Deadly, fast-spreading fungal infection reaches Ohio hospital, nursing home patients

CLEVELAND, Ohio – Candida auris, a drug-resistant fungal infection that spreads easily in hospitals and nursing homes and can lead to death, is on the rise in Ohio.

Candida auris cases tripled from 2019 to 2021, and treatment-resistant cases are also on the rise, according to national surveillance data.

The Centers for Disease Control through the end of 2022 reported 79 cases in Ohio of Candida auris – also called C. auris. But since then, the latest data from the Ohio Department of Health shows a sharp increase, with 416 cases through mid-March.

Looking at Cuyahoga County and surrounding areas, 101 cases were counted in Cuyahoga County, four in Summit County and four in Lorain County. Other Greater Cleveland counties reported no cases of the fungal infection, according to state health records.

By December, there were more than 8,000 cases across the United States.

Because it can remain on surfaces, spread through touch, and is difficult to treat and detect, the US Centers for Disease Control and Prevention recently rated Candida auris as an urgent threat, the highest level of concern of the agency.

“In Ohio, even though we don’t have a lot of it right now, it can spread very quickly,” said Mahmoud Ghannoum, professor of dermatology and pathology at Case Western Reserve University School of Medicine and director of the Center for Medical Mycology. in University Hospitals.

“It’s very difficult to diagnose this organism,” Ghannoum said. “It could be out there and people won’t even know it.”

State health officials recommend that people wash their hands frequently when visiting loved ones at a health care facility, postpone visits if they are sick, and ask health care providers to perform hand hygiene (washing hands or using sanitizer) when enter the room.

Candida auris mainly affects people who have other medical conditions, especially those who have frequent hospital stays or live in nursing homes, according to the Ohio Department of Health.

The fungus can be contracted through contact with contaminated surfaces or medical equipment or spread from person to person. It can live on the surface for up to two weeks.

There is a 30% to 60% fatality rate, although many of those infected had co-morbidities or other diseases that increased the risk of death, according to federal health officials.

“In some patients, this yeast can enter the bloodstream and spread throughout the body, causing serious invasive infections,” the CDC said. “Patients who have been hospitalized for a long time, have a central venous catheter, or other lines or tubes entering their body, or have previously received antibiotics or antifungal medications, appear to be at the highest risk. high infection rate with this yeast. “

Other risk factors include recent diabetes, recent surgery, and use of antibiotics and antifungal drugs. According to federal health records, infections have been found in patients of all ages, from premature babies to the elderly.

“If you have an underlying disease, then it becomes a big issue,” Ghannoum said.

Cases and transmission of Candida auris infection have increased in recent years, with a dramatic increase in 2021.

The fact that Candida auris does not respond to many antifungal drugs makes it difficult to treat, Ghannoum said.

The Ohio Department of Health is working closely with local health departments and health care facilities where Candida auris has been identified, implementing enhanced cleaning and screening to identify asymptomatic people, the agency said.

Ghannoum and a research team recently received a $3 million grant from the National Institutes of Health to investigate ways to treat and prevent Candida auris infections.

The five-year grant allows a team, led by Case Western Reserve School of Medicine and University Hospitals, to evaluate an antifungal drug developed by a New Jersey-based biotech company.

Ghannoum is the principal investigator of the study. Thomas McCormick, an associate professor of dermatology at Case Western Reserve University School of Medicine and the Department of Dermatology at University Hospitals, also leads the investigation team.

Candida auris was first detected in the United States in 2016, and has since been identified in at least 25 states. The number of cases began to rise in 2021, possibly due to the disruption of the health care system by COVID-19, according to the CDC.

When first discovered, the cases appeared to be imported. But recently, healthcare transmission is responsible “for most, if not all, cases,” the CDC said in a recent document.

Candida auris is more difficult to identify than other, more common types of fungi. For its identification, special laboratory blood tests are needed. People can have this fungus on their skin but have no symptoms of an infection.

Both Candida auris and C. diff – also known as Clostridioides difficile – can easily spread in healthcare facilities and contaminate commonly touched surfaces. But the two infections are caused by different organisms and have different treatments, health experts said.

Julie Washington covers health care for cleveland.com. Read previous stories at this link. Also:

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