Rare 'Superbug' Strikes Maryland Patient: CDC

A potentially dangerous "superbug" that is resistant to major treatments has infected a Maryland patient, according to the Centers for Disease Control and Prevention. Sixty-one cases of "Candida auris," a multi-drug-resistant fungus that is emerging globally, have been identified in six states, with the most cases in New York, according to the agency.

New York had 39 cases, followed by 15 in New Jersey. The remaining states are Illinois, with four, and Indiana, Maryland and Massachusetts, each with one case. Medical experts say the fungus has been found on the skin and clothing of patients and hospital workers and can move from one person to another in hospitals, unlike other invasive yeast infections. Outbreaks are possible in medical facilities because the fungus can live on contaminated objects such as bedrails, chairs and other equipment, and on the hands of health care providers.

“It’s acting like a superbug," said Paige Armstrong, CDC Epidemic Intelligence Service officer. "Without appropriate infection control and really a rigorous response, [it] could lead to even more cases in the United States.” SIGN UP: Get Patch’s daily newsletter and real-time news alerts, or like us on Facebook. Or, if you have an iPhone, download the free Patch app

Fragile hospital patients most at risk by the stubborn yeast infection are newborns and the elderly, reports ABC News. Surgical patients, those who have used catheters, and patients with diabetes are particularly at risk. The infection is typically diagnosed in patients after they've been in hospitals for several weeks.

Armstrong said the increase in global cases and travel have likely had an impact on the United States, where cases have increased by more than 800 percent since the fall. But the Centers for Disease Control said it couldn't explain why New Jersey and New York have had the biggest impact. The fungus was first found in a man’s ear in Japan in 2009, according to the CDC.

“We’re very alarmed because some strains of C. auris in other countries are resistant to all three major classes of antifungal drugs, which we’ve never seen before," Dr. Tom Chiller, chief of the Centers for Disease Control and Prevention's mycotic diseases branch, told Consumer Reports. "We're taking as proactive and aggressive an approach as possible to try to keep it in check in the United States.”

The fungus is different because if acts like a bacteria, causing serious wound and bloodstream infections in people who are already hospitalized and ill, reports National Geographic. Like these bacteria, it causes overwhelming infections that overtakes the immune system and doesn’t respond to drugs.

In a special edition of its weekly bulletin in November 2016, the CDC said it received initial reports of seven sick patients in New York, New Jersey, Maryland, and Illinois; of those infected, four people died. CDC officials said none of the cases were related, but four of them — two in Illinois and one each from New Jersey and Maryland — were cared for in the same facilities at different times.

“We need to act now to better understand, contain and stop the spread of this drug-resistant fungus,” CDC Director Tom Frieden said in a CDC release. “This is an emerging threat, and we need to protect vulnerable patients and others."

If someone you care for is in a hospital, nursing home or physical rehabilitation facility, here are steps you can take to help prevent spread of the fungus, says Consumer Reports:

• Thoroughly wash your hands whenever you enter a patient's room, and insist health care providers do the same.
• Speak up if others aren't washing their hands correctly. (Health care providers do this less than half the time, according to the CDC.) Remind nurses, doctors and others to scrub up not only when they come into the room but also after handling a patient’s open wound, blood or bodily fluids, or even touching their skin.
• Make sure the hospital is cleaning properly. There’s no research yet available on the best disinfectant for C. auris, but the CDC recommends using the strongest disinfectants available.
• If the person is put on IV antibiotics in the ICU, ask whether it's really necessary, since those drugs can pave the way for fungus to flourish.

Candida auris grows as yeast, and symptoms include difficulty swallowing, burning, genital itching and sometimes a cheese-like discharge that looks white, according to the CDC.

Neil Gaffin, an infectious disease specialist at the Valley Hospital in Ridgewood, New Jersey, told CBS2 that the organism can be spread patient to patient, as well as via "environmental surfaces."

“What’s also unique about this organism is that it can actually stay on skin surfaces for prolonged periods of time, even months after the initial infection is cured,” Gaffin told CBS2.

Most of the Candida auris strains from U.S. patients showed some drug resistance, making treatment more difficult. Samples of Candida auris strains from other countries have been found to be resistant to all three major classes of antifungal medications.

Armstrong spoke publicly at a conference in Atlanta last week about the Candida auris, saying Colombia's neonatal intensive care units have been suffering through enduring outbreaks of Candida auris.

“What we were able to find out is that, in fact, it is colonized in people even after you get treated with antifungal medications, people still have it on their skin," Armstrong said at the conference. "And so this is something that we’ve never seen before with a fungus, or I should say we don’t usually see with a fungus."

— Includes reporting by New Jersey Patch Editor Tom Davis
CDC Photo