Nevada outbreaks studied at 9 local hospitals and 3 skilled nursing facilities

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State and federal health regulators are investigating outbreaks of a drug-resistant ‘superbug’ that can lead to serious illness at nine hospitals and three skilled nursing facilities in southern Nevada, revealed the state health department on Wednesday.

Overall, 19 facilities – 16 hospitals and three nursing facilities – have reported recent cases of Candida auris fungus. But not all of those facilities are experiencing outbreaks, according to the state Department of Health and Human Services, which investigates cases in acute care hospitals, acute care hospitals and long-term care facilities. qualified nurses.

From January 3 to Monday, 73 clinical cases of C. auris were identified and 92 cases in which individuals were “colonized” with the fungus but had no active infection. Colonized individuals show no symptoms of infection but have the fungus somewhere on their body, allowing them to spread the disease.

The state provided the data in a detailed response to an investigation by the Las Vegas Review-Journal, which reported the outbreaks on Tuesday.

“As we have seen in southern Nevada, C. auris has caused outbreaks in healthcare facilities and can be spread through contact with affected patients and contaminated surfaces and equipment,” the department said in its response. .

C. auris can cause bloodstream infections and even death, especially in hospitalized and nursing home patients with serious medical conditions. More than one in three patients die from an invasive C. auris infection, such as an infection affecting the blood, heart or brain, according to the Centers for Disease Control and Prevention, which has deployed a team to southern Nevada. to help with the investigation. .

The state health department said there had been deaths among Nevada patients with C. auris, but it was unclear whether the deaths were due to the infection or the cause. other factors. He did not specify how many died.

The most common symptoms of an invasive infection are fever and chills that do not improve after antibiotic treatment for a suspected bacterial infection.

CDC deploys a team

The state Bureau of Public Health Investigations and Epidemiology has been investigating outbreaks since mid-April. The office is working with each health care facility and the CDC “to combat the spread of Candida auris by understanding its methods of transmission,” the state health department said.

Health regulators are identifying gaps in infection prevention practices at facilities, educating as needed about C. auris and reviewing facility policies and procedures aimed at stopping transmission, the department said.

The CDC has deployed a team to help with case finding and transmission control within health care facilities. The team “will visit health facilities experiencing an increase in cases to conduct environmental sampling, extraction of records, observations and interviews with staff”.

Neither the state health department nor the CDC has identified which southern Nevada facilities are “experiencing an increase in cases.”

But employees at Sunrise Hospital and Medical Center have been told the CDC will be on site this week and speaking with staff. A representative from the Sunrise Health System, which includes three acute care hospitals, said it was not releasing any case figures.

The University Medical Center said on Tuesday it had identified a cluster of cases. St. Rose Dominican said it identified one case at its three hospitals. The Valley Health System declined to say whether any cases had been identified at any of its six acute care hospitals.

Difficult to treat, prevent

Healthy people generally do not develop C. auris infections, the state said.

“Most people who get serious Candida infections already have other medical conditions, live in medical facilities such as nursing homes, have had medical treatment outside the United States, or have lines or tubes that go into their body,” he said.

These factors put individuals at higher risk for infection, as do recent surgery, diabetes, broad-spectrum antibiotics, and antifungal use.

Candida auris, first identified in Japan in 2009, is a serious global health threat, according to the CDC. Once rare, the infection has become more common and is often resistant to several drugs typically used to treat Candida infections. Some of its strains are resistant to all types of antifungals.

In 2021, nearly 1,300 confirmed or probable cases of C. auris were reported, according to CDC data, with triple-digit cases in California, Florida, Illinois and New York. Nevada had two reported cases last year.

C. auris infections are not only difficult to treat, but difficult to prevent. The fungus “can colonize patients for many months, persist in the environment, and be resistant to some disinfectants commonly used in healthcare settings that are not specific to eliminating C. auris from surfaces,” the report said. State.

However, he said “early detection and infection control can limit the spread of C. auris.”

Contact Mary Hynes at [email protected] or 702-383-0336. Follow @MaryHynes1 on Twitter.

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