Health officials warn of fungus 'superbug' outbreaks in Dallas, DC | TheHill

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The Hill 23 July, 2021 - 07:23am 43 views

'Superbug' fungus spread in two cities, health officials say

Yahoo News 23 July, 2021 - 10:00am

The “superbug” outbreaks were reported in a Washington, D.C, nursing home and at two Dallas-area hospitals, the Centers for Disease Control and Prevention reported. A handful of the patients had invasive fungal infections that were impervious to all three major classes of medications.

“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 fungus, Candida auris, is a harmful form of yeast that is considered dangerous to hospital and nursing home patients with serious medical problems. It is most deadly when it enters the bloodstream, heart or brain. Outbreaks in health care facilities have been spurred when the fungus spread through patient contact or on contaminated surfaces.

Health officials have sounded alarms for years about the superbug after seeing infections in which commonly used drugs had little effect. In 2019, doctors diagnosed three cases in New York that were also resistant to a class of drugs, called echinocandins, that were considered a last line of defense.

In those cases, there was no evidence the infections had spread from patient to patient — scientists concluded the resistance to the drugs formed during treatment. 

The new cases did spread, the CDC concluded.

In Washington, D.C., a cluster of 101 C. auris cases at a nursing home dedicated to very sick patients included three that were resistant to all three kinds of antifungal medications. A cluster of 22 in two Dallas-area hospitals included two with that level of resistance. The facilities weren't identified.

Those cases were seen from January to April. Of the five people who were fully resistant to treatment, three died — both Texas patients and one in Washington. 

Lyman said both are ongoing outbreaks and that additional infections have been identified since April. But those added numbers were not reported. 

Investigators reviewed medical records and found no evidence of previous antifungal use among the patients in those clusters. Health officials say that means they spread from person to person.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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US sees first Candida auris cases resistant to all drugs in untreated people

STAT 23 July, 2021 - 10:00am

Exclusive analysis of biotech, pharma, and the life sciences

By Helen Branswell July 22, 2021

Candida auris, or C. auris, which was first seen in 2009, has been highly resistant to the few available treatment options for several years, leaving people who treat and study fungal diseases concerned about the toll this superbug could take, particularly on severely ill patients. That there are now so-called pan-resistant cases in people who had never been treated with antifungal drugs is particularly unnerving, experts said.

The CDC reported on five cases, three in Washington, D.C., and two in Texas. In both locations, the cases were clustered within facilities. The facilities were not identified, but the fungus is most commonly diagnosed in very sick people who are in specialized long-term facilities.

There was no known link between the Washington and Texas cases. The cases were outlined in the CDC’s online journal Morbidity and Mortality Weekly Report.

Pan-resistant C. auris was first detected in 2019 in people who developed resistance while being treated with antifungal drugs. What makes these newly reported cases more concerning is the fact none of the people had been treated with antifungal drugs prior to the diagnosis. That means the strain of C. auris they caught was already pan-resistant.

“This is the first time that we’ve actually identified clusters with common health care exposures in the same facilities and among patients who had not received antifungals,” Meghan Lyman, a medical officer in the mycotic (fungal) diseases branch in CDC’s National Center for Emerging and Zoonotic Infectious Diseases, told STAT in an interview.

There are only three classes of antifungal drugs — azoles, polyenes, and echinocandins. Most C. auris cases detected in the United States are resistant to azoles (85%) and many are resistant to polyenes (38%). The overwhelming majority (99%) have been susceptible to echinocandin drugs, so they are the first-line therapy when C. auris is detected.

These pan-resistant cases raise questions about how long and how well the first line will hold.

“These cases are ones where the options are really limited. There are few treatment options for these patients who have clinical infections. And the fact that now it can spread, it’s not just in patients who are already getting treatment … means that a greater proportion of patients may have pan-resistance and [may] develop clinical infections that are potentially untreatable,” Lyman said.

In the Texas outbreak, in addition to the two pan-resistant cases, there were five patients with C. auris that was resistant to both echinocandins and fluconazole, an antifungal drug in the azole class. The seven were detected in two different facilities, but there was movement of patients between the two institutions.

The 30-day fatality rate among the patients in both the Texas and Washington outbreaks was 30%, but because these people were all severely ill, it isn’t possible to say whether the C. auris infections caused or contributed to their deaths.

In some of cases, C. auris was found on the skin of people; in epidemiological terms, they were “colonized.” In that state, the fungus isn’t causing disease, but people who are colonized can spread the fungus to other patients and may eventually go on to have active infections themselves. Lyman said between 5% and 10% of people found to be carrying C. auris will go on to have active or “invasive” infections later.

Though this report deals with a mere five cases, it’s likely there are more, Lyman said. The Covid-19 pandemic has siphoned off surveillance capacity for other pathogens; even before the pandemic, surveillance for drug-resistant fungal infections was spotty.

“It might be under-detected. That’s very likely,” she said.

Despite the inadequacy of surveillance, researchers say the pandemic has fueled an increase in C. auris cases. A number of people who become severely ill with Covid require care in the types of facilities where these fungal infections are being found.

“We tend to see transmission and see cases among patients who are in these high-acuity, long-term care facilities … that have very high-acuity, very sick patients like ones who are on ventilators or have tracheostomy or other invasive medical devices,” Lyman said. “Getting Covid and then having these complications put them at higher risk for acquiring Candida auris.”

Facilities treating these kinds of patients should be on high alert for C. auris, she said, because finding it quickly is key to containing it.

“With all this spread that we’ve been seeing across the country we’re really encouraging health departments and facilities to be more proactive instead of reactive to identifying Candida auris in general. Because we’ve found that controlling the situation and containing spread is really easiest when it’s identified early before there’s widespread transmission.”

Helen covers issues broadly related to infectious diseases, including outbreaks, preparedness, research, and vaccine development.

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By Helen Branswell

By Elizabeth Cooney

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By Mike Stobbe — Associated Press

Reporting from the frontiers of health and medicine

Health officials warn of superbug fungus

WSB Atlanta 23 July, 2021 - 08:04am

The fungus, Candida auris, has been found in a handful of patients at a nursing home in Washington, D.C., and two hospitals in Dallas, Texas, The Associated Press reported.

The fungal infection has not been cured by all three major types of antifungal medications.

Candida auris is a type of yeast that can pose a danger to patients. It can be deadly if it enters the bloodstream, heart or brain and can be spread through patient contact or on contaminated surfaces, the AP reported.

In 2019, doctors had found three cases of the fungus that were resistant to echinocandins, or the last medication doctors used against fungal infections.

In those cases, the fungus became resistant to the medication during treatment.

But in the recent cases, which occurred from January to April, the cluster, which consisted of 101 people, was spread between patients, according to the CDC. There were also 22 cases in the Dallas area, according to the AP.

Five people had conditions that did not respond to any of the antifungal treatments. Two people died in Texas and one person died in D.C., the AP reported.

CDC officials combed over patient files and found no previous use of antifungal treatments, so they said that indicated person-to-person transmission.

For more on the outbreak, click here. For more information on Candida auris from the CDC, click here.

Morning Roundup: CDC Reports 'Superbug' Fungus In DC Nursing Home | DCist

DCist 23 July, 2021 - 03:41am

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CDC: Untreatable 'superbug' outbreak discovered at DC nursing home

FOX 5 DC 23 July, 2021 - 02:19am

The CDC is reporting that a potentially dangerous and untreatable 'superbug' has been found at a DC area nursing home.

The CDC is reporting that a potentially dangerous and untreatable 'superbug' has been found at a DC-area nursing home. Now, healthcare facilities in the area are told to be on high alert. 

U.S. health officials announced Thursday they now have evidence that the fungus spread in the nursing home as well as two hospitals in the Dallas area.

"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.

A handful of the patients had invasive fungal infections that were impervious to all three major classes of medications, which the CDC has classified as outbreaks. 

"Since the 2010s, we've been tracking a fungus called Candida auris, which is very concerning because it is multi-drug resistant," said Dr. Amesh Adalija with Johns Hopkins Center for Health Security. "It emerged on three continents simultaneously snd it has really been something that can cause a lot of damage when it gets into nursing homes or into health care facilities because it preys on those who are already frail, already ill." 

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Candida auris is a harmful form of yeast that is considered dangerous to hospital and nursing home patients with serious medical problems. It is most deadly when it enters the bloodstream, heart or brain. Outbreaks in health care facilities have been spurred when the fungus spread through patient contact or on contaminated surfaces.

Health officials have been sounding the alarm for years about the superbug after seeing infections in which commonly used drugs had little effect. In 2019, doctors diagnosed three cases in New York that were also resistant to a class of drugs, called echinocandins, that were considered a last line of defense.

In those cases, there was no evidence the infections had spread from patient to patient — scientists concluded the resistance to the drugs formed during treatment.

The new cases did spread, the CDC concluded.

In Washington, D.C., a cluster of 101 C. auris cases at a nursing home dedicated to very sick patients included three that were resistant to all three kinds of antifungal medications. Officials have not yet identified the nursing care facility. 

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A cluster of 22 in two Dallas-area hospitals included two with that level of resistance. The facilities weren't identified.

Those cases were seen from January to April. Of the five people who were fully resistant to treatment, three died — both Texas patients and one in Washington.

Lyman said both are ongoing outbreaks and that additional infections have been identified since April. But those added numbers were not reported.

Investigators reviewed medical records and found no evidence of previous antifungal use among the patients in those clusters. Health officials say that means they spread from person to person.

This material may not be published, broadcast, rewritten, or redistributed. ©2021 FOX Television Stations

Untreatable, deadly 'superbug' fungus outbreak reported at two North Texas hospitals

FOX 4 Dallas 22 July, 2021 - 09:42pm

An untreatable 'superbug' fungus outbreak has been reported at two North Texas hospitals, the CDC reports.

An untreatable 'superbug' fungus outbreak has been reported at two North Texas hospitals, the CDC reports.

Formally known as Candida Auris, the fungus is a form of yeast that can be deadly to hospital and nursing home patients who have serious medical problems.

It can be spread through patient contact pr contaminated surfaces.

"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.

Health officials have sounded alarms for years about the superbug after seeing infections in which commonly used drugs had little effect. In 2019, doctors diagnosed three cases in New York that were also resistant to a class of drugs, called echinocandins, that were considered a last line of defense.

In those cases, there was no evidence the infections had spread from patient to patient — scientists concluded the resistance to the drugs formed during treatment.

The new cases did spread, the CDC concluded.

In Washington, D.C., a cluster of 101 C. auris cases at a nursing home dedicated to very sick patients included three that were resistant to all three kinds of antifungal medications. A cluster of 22 in two Dallas-area hospitals included two with that level of resistance. The facilities weren't identified.

Those cases were seen from January to April. Of the five people who were fully resistant to treatment, three died — both Texas patients and one in Washington.

Lyman said both are ongoing outbreaks and that additional infections have been identified since April. But those added numbers were not reported.

Investigators reviewed medical records and found no evidence of previous antifungal use among the patients in those clusters. Health officials say that means they spread from person to person.

FOX 4 reached out to several local and state agencies for information about the hospitals, but none of them could provide any.       

This material may not be published, broadcast, rewritten, or redistributed. ©2021 FOX Television Stations

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