Proper sanitation precautions can prevent disease outbreaks from occurring in nursing homes. Yet, sometimes regular handwashing and patient isolation is not enough. As “7 On Your Side” found after investigating a deadly superbug in a Brooklyn nursing home, certain conditions appear to have no source.
The disease in question is Candida Auris, a yeast that targets compromised immune systems and infects the blood. Compared to other candida-based infections, traditional treatments don’t have the same effect, tests do not always identify it clearly and fatality rates are far higher. Based on data from the Centers for Disease Control and Prevention, Candida Auris cases have been on the rise, especially in nursing homes and other healthcare settings. Here’s what you should know.
A Growing Concern
The CDC has identified nearly 800 cases of Candida Auris, with two-thirds in New York, New Jersey and Connecticut. Unfortunately, in 51 percent of these cases, the patient passed away. A Health Department assessment further found that 541 other individuals carried the disease without displaying any symptoms, which typically include fatigue and fever.
Dr. Lynn Sosa, Connecticut’s deputy state epidemiologist, called Candida auris the top threat among resistant infections. “It’s pretty much unbeatable and difficult to identify,” she told the New York Times. The first confirmed case in our state was in June 2017.
According to documentation from the CDC, Candida Auris was officially identified in 2009 in Japan, although strain samples date back to 1996 in South Korea. Upon entering the bloodstream, this type of yeast spreads throughout the body to create a series of invasive infections that don’t respond to most antifungal drugs.
The condition may further affect the respiratory and central nervous systems, internal organs and skin. Individuals who have been hospitalized for lengthy periods of time, have tubes or catheters entering their body or have recently used antibiotics or antifungal medications appear to be the most vulnerable.
This yeast family includes 20 different types that congregate on the skin, in mucous membranes and the gastrointestinal tract, without causing infections. In the right amount, it’s part of the human body’s gut flora, but overgrowth can occur, potentially leading to this fatal, blood-infecting disease.
How An Outbreak Happens
In general, patients with compromised immune systems are more susceptible to picking up this disease, including:
- Anyone who uses antibiotics or antifungal medication long-term
- Those who’ve recently had surgery
- Patients in intensive care units
- Those who rely on indwelling medical devices
- Those who receive total parenteral nutrition
Around the world, roughly 60 percent of infected individuals die. In the US, close to 30 percent of all cases are fatal. Unlike with flu outbreaks, several factors have caused Candida Auris to spread:
- Tests don’t always identify it. Without specialized equipment and testing methods, the disease may resemble another species of Candida and patients don’t receive appropriate treatment.
- No one’s fully sure how it spreads. As with many outbreaks in nursing homes, shared contact through equipment, medical personnel and the environment allows Candida Auris to spread. Even when homes put appropriate protocols into place, patients may still manage to pick up the disease.
- It’s not easy to treat. Due to the rising temperature from climate change, research indicates that Candida Auris has adapted and the human body’s natural temperature creates an environment for it to thrive. As a result, doctors have to prescribe multiple classes of antifungal drugs in higher doses to get rid of the infection.
Tips for Controlling Candida Auris
What if a nursing home or hospital identifies a patient with Candida Auris? Based on CDC recommendations:
- The patient needs to be placed in a single-patient room.
- Staff must follow appropriate hand-hygiene procedures and fully disinfect the patient’s environment and any equipment used. In doing so, staff must always wear gloves in the patient’s room and avoid touching areas outside with the gloves. Hands must be washed before putting the gloves on and after taking them off.
- Disinfecting must involve both high-touch surfaces and areas farther away, from bedside tables to the windowsills.
- Any room where the patient receives care must be disinfected after.
- Nursing homes must develop an inter-facility communication plan concerning the patient’s status. Always inform the other party ahead of time before the patient is transferred.
- The facility must examine anyone who comes in contact with the infected patient for the presence of Candida Auris and routinely monitor the facility for patients who start to display symptoms.
- The patient must be reassessed for the presence of Candida Auris every three months.
Did your loved one battle a superbug like Candida Auris during a nursing home stay? When negligence is behind the spread, it’s time to hold the facility and its staff accountable for exposure to an extremely life-threatening disease. To speak with a lawyer about your claim, contact us today.