Outbreak of rare, fungal superbug reported at Oregon hospital

SALEM, Ore. —Two patients at an Oregon hospital contracted a dangerous fungal infection during an "outbreak" of Candida auris, a type of yeast rare to the United States, the Oregon Health Authority reported Tuesday.

A case — the first ever found in Oregon — was detected at Salem Health Dec. 11 and confirmed Dec. 17 in an individual who had "recent international health care exposures."

Two already-hospitalized patients then came down with the infection on Dec. 23 and Dec. 27.

Salem Health and OHA are working to notify health care facilities that had received transfer patients from the "affected units" at Salem Health. It was not immediately clear which units at Salem Health are impacted by the outbreak.

The fungus, also called C. aris, can cause infections in wounds or the bloodstream and is most dangerous for hospital or nursing home patients who have serious medical conditions, weakened immune systems or have tubes or lines entering their body, according to OHA and the Centers for Disease Control.

The risk of infection to otherwise healthy people is "extremely low."

Since 2013, about 1,150 clinical cases of Candida auris have been identified in the United States. The CDC describes it as presenting a "serious global health threat."

“Candida auris is an emerging pathogen of concern because it can cause serious infections, particularly in those with serious medical problems, and can be resistant to the antifungal drugs we have to treat it,” Rebecca Pierce, Healthcare-Associated Infections Program manager with the OHA, said.

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Pierce went on to say the fungus in the cases at Salem Health is responding to existing treatments.

OHA, CDC and Salem Health are developing and implementing a plan to stop the spread of Candida auris at the hospital, Jasmin Chaudhary, medical director of infection prevention at Salem Health said.

The measures put into effect include: ensuring frequent disinfection of patients' health care environments; using transmission-based precautions for those infected or colonized with candida auris; and adhering to hand-washing protocols.

What is Candida auris?

A fungal disease that spreads in healthcare settings, causing invasive infections. First identified in Japan in 2009, Candida auris began occurring in the U.S. in 2015.

The CDC is particularly concerned about it because C. auris is difficult to diagnose, requiring specialized lab work, and prompt action is necessary to prevent it from spreading. In addition, most of its strains have proven resistant to at least one anti-fungal drug.

Who does it affect?

Candida auris typically preys on patients who already have a serious medical condition or a compromised immune system, especially those who require intrusive treatment with a tube going into their body.

Healthy people typically don’t get infected, but they should clean their hands with soap and water or hand sanitizer when they come in contact with a patient who has the disease or with surfaces or equipment in the room.

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The CDC says 30-60% of the people who have contracted C. auris infections have died, but it also points out many of them were at increased risk because of serious illnesses.

What are the symptoms?

Symptoms vary, but the most common ones are a fever and chills that don’t respond to antibiotics. In those cases, specialized lab tests are required to ascertain whether the condition is Candida auris. The disease often causes infection in the bloodstream, the ears or in a wound.

How is it treated?

The CDC said the majority of C. auris infections respond to treatment with a class of antifungal medications known as echinocandins. But some strains resist all three main classes of drugs, requiring higher doses of multiple medications.

How to avoid it?

If you’re around a patient with C. auris, wash your hands and request that others who are exposed do the same, including healthcare workers.

The CDC recommends that patients with Candida auris be placed in a single room that may require frequent cleaning with a high-grade disinfectant.

USA Today reporter Jorge L. Ortiz contributed to this article.

Follow Connor Radnovich on Twitter at @CDRadnovich.

This article originally appeared on Salem Statesman Journal: Oregon hospital reports outbreak of rare superbug Candida auris