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Drug-Resistant Fungus Spreads Inside Nursing Home Amid COVID Battle

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Candida Auris Is an Invasive Fungi That is Spreading in Health Care Settings and Proving to Be Drug-Resistant

On Thursday, July 22, 2021, U.S. health officials presented evidence that an untreatable fungus is now spreading in two Dallas-area hospitals and inside a nursing home located in Washington, D.C. Candida auris is a super bacterium the Centers for Disease Control and Prevention (CDC) deems an urgent threat. The fungus is extremely difficult to eradicate even with hospital-grade disinfectants and response plans, reminding health care leaders yet again why infection control is so critical in maintaining healthy human populations

Just as awful, commonly used drugs have little effect on abolishing the super fungus. Moreover, a resistant class of drugs, called echinocandins, once considered a last line of defense, is even useless in some cases, allowing Candida auris to spread quickly among healthcare-reliant populations. 

  • Washington, D.C.: A cluster of 101 cases at a nursing home dedicated to very sick patients included three resistant to all three kinds of antifungal medications. 
  • Dallas: A cluster of 22 in two different hospitals included two with that level of resistance. The facilities have not been publicly identified. Those cases were seen from January to April. 

Of the five fully resistant to treatment, three died — both Texas patients and one in Washington. Nearly half of all patients who contract Candida auris die within 90 days. CDC investigators say they reviewed medical records and found “no evidence of previous antifungal use among the patients in those clusters.” 

The fungus moves as a highly volatile yeast that is most noticeably found throughout hospital patient and nursing home resident rooms, on patients’ skin, and daily shared medical devices and equipment such as blood pressure cuffs, bed rails, wheelchairs, and medication carts. The most severe cases of infection from the fungus often occur among nursing home patients with serious medical problems and in skilled nursing facilities that care for ventilated patients or in long-term acute care settings. This is because it’s too easily spread through patient contact and when surfaces have become contaminated, leading to deadly outbreaks. 

“This is really the first time we’ve started seeing clustering of resistance,” in which patients seemed to be getting the infections from each other, said the CDC’s Dr. Meghan Lyman.

The Associated Press is reporting that “a handful of the patients had invasive fungal infections that were impervious to all three major classes of medications.” Medical researchers say the development of new antifungal drugs is urgent to improve human health outcomes. Over the past 5–10 years, the CDC reports it has seen some worrisome trends in invasive fungi, including Candida auris, Aspergillus, Coccidioides immitis, and Coccidioides posadasii (or Valley Fever), and Sporothrix brasiliensis.

The Underestimated Problem of Candida Auris

According to the U.S. National Institutes of Health, these infections cause more than 1.6 million deaths worldwide every year. And as stated earlier, the microorganisms responsible for them are also starting to evade the small supply of antifungal drugs.

Candida auris can easily be spread from person to person when the proper prevention practices are not in play. Even worse, exposure to the super fungus can be deadly for nursing home residents and long-term care patients because:

  • It transmits more quickly like a bacteria than a fungus.
  • Candida auris mortality rates range anywhere from 30% to 60%
  • The fungal pathogen is frequently resistant to drug treatment.
  • Four out of five patients with Candida auris will have had an intravenous infusion. A half or more have a feeding or breathing tube or urinary catheter, all standard devices used in nursing home settings.
  • It often doesn’t respond to traditional ammonia cleaners, and contaminated surfaces have caused some nursing homes, long-term care facilities, and hospitals to empty entire wings of nursing home residents.
  • The super fungus can easily trigger a deadly infection for patients with compromised or weakened immune systems, like elderly nursing home residents who have recently battled COVID-19. Still, it can sometimes infect healthy people as well.

A 2019 Frontiers in Microbiology journal report published by the National Institutes of Health titled, The Still Underestimated Problem of Fungal Diseases Worldwide, says:

“The negative impact of any infectious disease is usually higher in neglected populations. Lack of access to healthcare, underfunded healthcare, and delayed diagnosis lead to higher burden of fungal diseases. The economy of countries in developing countries strongly relies on agricultural production. Another fungal blight, if not managed properly, can still have disastrous economical and societal consequences.”

No matter where you live, every family member who has a loved one in a nursing or other long-term care facility should understand what Candida auris is. And then, contact administrators and determine what steps are being taken to identify at-risk residents, even if the fungus is not present now.

A Review of Candida Auris Outbreaks in U.S. Nursing Homes

Candida auris isn’t new to nursing homes. In 2019, the drug-resistant super fungus plagued nearly 50% of Chicago-area nursing homes. The Chicago Tribune reported that ninety-five of the known cases in the state occurred in or around Chicago, with 56 in suburban Cook County, seven in DuPage, Lake, and Will counties, and another three near St. Louis

At the time, Levin & Perconti attorney and partner Steven Levin responded to news of the 2019 spread, “This is not new and continues to be unacceptable. And, given the lengths long-term care facilities’ corporate owners will go to keep secret the awful conditions and poor care behind their closed doors – we might never know the extent of danger these super funguses pose on our loved ones until it is too late.”

Can prevention and quick diagnosis of a super fungus help, though? In March 2020, amid the start of the COVID-19 pandemic, the deadly pathogen Candida auris unexpectedly appeared at Scripps Memorial Hospital La Jolla, California, when a patient tested positive for the infection. Infection preventionists and officials from the San Diego County department of public health prevented this single case from becoming a full-blown outbreak.

However, more significant numbers of COVID-19 hospitalizations and more immunocompromised people reliant on long-term care may be fueling a new spread of the invasive fungi. To make matters worse, understaffing, especially when intentional, remains an unimaginable hurdle in preventing illnesses and dangers from spreading inside our nation’s nursing homes. More than one million residents who live in long-term care facilities, such as nursing homes and rehabilitation centers, have been suffering from inadequate staffing for decades, and the Coronavirus crisis only magnified the proof. Most victims that come from these understaffed homes have suffered a combination of injuries and face a higher risk of becoming in contact with deadly super-bugs because of it.

More Nursing Home Staff Equals Less Resident Health Issues and Deaths

In nursing homes with adequate staff, nurses and nurse aides are less likely to be stressed and rush and can spend more time with residents to identify symptoms of infection and address bacteria-spreading actions at the onset. Presently, understaffed nursing home teams have suffered disproportionately during the pandemic, especially certified nursing assistants (CNAs) who consist as much as 40% of a nursing home’s workforce. These employees support the daily needs of residents and long-term care patients, such as dressing, bathing, food preparation and eating, rehabilitation, hygiene, keeping communication with family members, socialization, and ambulating.

When the required staff do not have support or are treated poorly, it ultimately puts nursing home residents in harm’s way. Among many other oversights, call lights will be missed, hygiene becomes unhealthy among residents, patient morale, safety, and mental health reach low levels, medication routines lapse or become too familiar, and rotating residents at risk for bed sores are quickly forgotten.

The nursing home industry is facing a shortage of staff, especially nursing assistants, nationwide. Still, as one of the nation’s top-rated nursing home abuse and neglect attorneys, we see each day how the intentional understaffing and inadequate training of nursing home staff produces deadly outcomes for residents. And, it is almost always driven by poor leadership and failed facility management.

Working With the Nation’s Leading Nursing Home Abuse & Neglect Attorneys

If you suspect neglectful hygiene practices responsible for a super fungus spread in a long-term care home or health care facility, or the mistreatment of a severe infection of a nursing home resident as the cause of their illness or untimely death, please contact Levin & Perconti, one of the nation’s most recognized and respected leaders in the areas of elder abuse and nursing home negligence litigation. Our experienced team of attorneys handle cases throughout the U.S., continue to win significant lawsuits involving nursing home acquired infections, and are currently representing clients who became victims of COVID-19 failures in long-term care settings. Call us toll-free at 877-374-1417 or in Chicago at 312-332-2872 today. The call is free and confidential.