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Potentially deadly fungus only identified in Clark County


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A potentially drug-resistant fungus was identified only in Clark County healthcare facilities since 2021, according to the Nevada Department of Health and Human Services.

Candida Auris or C. auris is spreading and is dangerous because it resists treatment by common antifungal medications. It primarily affects those with underlying health conditions. It's now reported in more than half of the 50 states, which represents a "dramatic increase" in caseload and transmission of C. auris, according to a paper by researchers at the Centers for Disease Control and Prevention who published their findings last week in the Annals of Internal Medicine.

Data from the Nevada Department of Health and Human Services shows a total of 1,129 cases from 34 facilities reported between 2021 and 2023 in Clark County. The state reports a total of 174 cases in 2023 as of March 6. There are 79 clinical cases and 95 colonized cases. A person colonized with C. auris means the fungus is somewhere in their body but does not have an infection or symptoms of infection.

Sunrise Hospital and Medical Center have the most total cases out of the healthcare facilities on the list, with 192.

"The reason Sunrise has the higher numbers is we are acutely aware that this organism is endemic in our community," Steven Merta, Chief Medical Officer at Sunrise Hospital and Medical Center, said. "By identifying the first case and working with the Southern Nevada Health District, we actually went looking for the organism, identifying high-risk patients and actually culturing them as they come in to identify those individuals to appropriately care for them."

Merta said the first case was identified in September 2021. There has not been an outbreak inside of the facility because of healthcare workers focusing on strategic testing by identifying high-risk patients who are critically ill, have weak immune systems, or are coming to the hospital from long-term care facilities.

"Therefore, we can then isolate them correctly," Merta said. "We can provide our colleagues and visitors with appropriate PPE (personal protective equipment) to prevent the spread. We have high-level disinfection. We're using advanced infection prevention techniques. The fact that we know it's here and we've identified the individuals coming into the facility, that allows us to better care for those individuals, and to protect not only our patients but also our staff, and families."

The Centers for Disease Control and Prevention website tracks the spread of the fungus and showed Nevada reporting 384 cases in 2022, the most in the United States. The CDC reported 30-60 percent of people with C. auris infections have died, however many of those people had other serious illnesses.

"The average healthy individual coming from home into the hospital, even if you're a carrier, which a lot of them are, it's not an organism that is going to hurt them at that time," Merta said. "Most people don't come to the hospital knowing they have C. auris, they come from another problem, whether it's COPD (Chronic Obstructive Pulmonary Disease), or a bad infection, a foot ulcer, or a leg ulcer. Then we identify that they're carrying C. auris on top of other things."

The big concern is if the fungus gets in the patient's bloodstream.

"It can cause a wound infection or what we call a septic picture," Merta said. "But it's not like what you routinely think about and chickenpox where you've got blisters, or little vesicles. It's more of an infection that gets into the skin, and that's where it colonizes."

Merta said the best way to prevent the spread is by disinfecting surfaces and washing hands.

"We're going to have to learn to live with it," Merta said. "It's endemic, it's here in our community, it has been, and it's in your homes in many cases. So, what's most critical is to wash your hands; I mean, washing your hands is the simplest and easiest way to prevent the spread of any organism."

A spokesperson from the Department of Health and Human Service state emailed News 3 and said, "the Nevada Office of Public Health Investigations and Epidemiology (OPHIE) Healthcare Associated Infection Program (HAI) has continued to work closely with each facility and looks to the Centers for Disease Control and Prevention (CDC) for support and guidance to mitigate and combat the spread of C. auris. The HAI program also continues to work with the Antimicrobial Resistance Regional Lab Network (ARLN) and the Nevada State Public Health Laboratory (NSPHL), who assist with the identification of cases through laboratory testing. "

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The state said there are protocols in place when the HAI program is notified of a colonized or infected case, including screening at the facility with the reported case and the previous facility where the patient was located.

Screening is requested of any roommates and close contacts to identify any additional cases. Transmission prevention practices are reviewed with the facility to further prevent the spread of C. auris, the HAI Program provides the facility with education and tools, and state infection preventionist or HAI staff will perform an onsite assessment to identify any gaps in infection prevention and resources are provided to aid in closing the identified gaps. The HAI team continues to work closely with NSPHL regarding case identification.
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