Deadly New Infection Called Candida Auris Killing Nursing Home Patients
Normally we publish stories about efforts to curb Medicaid fraud in our nation’s hospitals, clinics and nursing homes. Recently we learned of a deadly new infection sweeping through some nursing homes in New York, Illinois and New Jersey. The infection is caused by a newly discovered fungus known as Candida Auris.
A decade ago the fungus wasn’t known to even exist. It was first discovered in Japan in 2009. It didn’t appear in the U.S. until four years ago. Since then, it has killed roughly 50 percent of its victims within 90 days.
This deadly fungus, resistant to drugs and extremely contagious, is becoming increasingly common in nursing homes. The fungus has infected nearly 800 people to date in the U.S., with most cases occurring in the New York/New Jersey and Chicago areas. Most of these patients are either nursing home residents or those who have spent a great deal of time in the hospital.
A Vulnerable Population
Nursing home residents, who often have weakened immune systems, are especially vulnerable to the devastation of “superbug” infections like Candida Auris.
The early symptoms of Candida Auris infection are associated with various maladies and include fever, fatigue, and body aches. For those with compromised immune systems, including the elderly, diabetic, and those with autoimmune diseases, these ordinary symptoms soon turn deadly.
Even with the best care and staff in place, nursing home residents may develop and succumb to a Candida Auris infection. If the nursing home care is less than stellar, the situation is even more dangerous. The infection easily passes from bed to bed, and patients can infect each other, as well as family, friends, and staff.
Healthy people can carry the infection but never suffer from any symptoms. That means aides and nurses who don’t wash their hands between patients or nursing homes that don’t frequently sanitize floors and bedding may be contributing to the rapid spread of this killer fungus.
In Chicago, some nursing homes found half of the patients living in dedicated ventilator units are infected with Candida Auris. In New York, approximately 400 nursing home patients to date are infected, with another 500 estimated as infected but not showing symptoms.
Last year, the Palm Gardens Center for Nursing and Rehabilitation in Brooklyn had six cases of Candida Auris. To date in 2019, the number of infections has climbed to 38. This facility has only a two-star rating from the federal government, which is below average. [Medicare maintains a free, easy to use website allowing anyone to check the ratings of nursing homes that accept Medicare or Medicaid patients]
Failure to Take Basic Good Hygiene Measures
Because Candida Auris is so easily spread, vigilance is required by anyone coming into contact with a person with the disease to avoid further spread. Basic protective measures include the use of disposable gowns for patients, wearing latex gloves when touching patients, frequent use of hand sanitizers and the posting of warning signs requiring the use of masks, gloves, and gowns outside infected patients’ rooms. However, common issues such as nursing home understaffing, inadequate hygiene, and poor infection control are aiding the spread of this and other drug-resistant pathogens.
Patients in these settings are often prescribed multiple antibiotics for various diseases, which boost drug resistance. In the case of Candida Auris, those already receiving treatment for other fungal infections are also at increased risk.
The best practices for reducing the spread of Candida Auris, according to American Nurse Today, include placing patients suspected of carrying the infection in a private room. This rarely happens in nursing homes.
Only a few selected staff members should care for the patient, another problem in already understaffed facilities. Since invasive devices such as urinary catheters and endotracheal tubes are a major avenue of infection, such devices should be used only when necessary and for as short a period as possible.
Patients should have their rooms cleaned daily with a hospital-grade disinfectant that can kill Candida auris – and this daily cleaning must prove thorough. After a patient died from Candida auris at Mount Sinai Hospital in Brooklyn in 2018, it was necessary to rip out the ceiling and floor tiles, as well as use special cleaning equipment, to eradicate the fungus from his room. It is unlikely most nursing homes make such an attempt at eradication after the death of a resident.
Some nursing homes are refusing to admit patients carrying Candida Auris. New York State is considering regulations requiring pre-screening of patients arriving at a hospital after a nursing home stay for the infection. Although the proposed requirements sound draconian, they may prove effective in battling this terrible new disease. There’s just one problem: Once a person is infected with Candida Auris, it appears to remain on the skin for good.
Simply because a patient is staying in a nursing home doesn’t mean he or she gives up their rights. Unfortunately, some nursing homes cut corners by understaffing and not doing appropriate testing when a patient is suspected of having a Candida Auris or other superbug.
Medicaid rules require skilled nursing facilities to have adequate staffing and practice proper sanitation. Facilities that do not can lose their certification.
If you suspect your nursing home isn’t following state and federal guidelines, contact your local state Medicaid Fraud Control Unit or call 1-800-Medicare.
If you are or a loved one have contracted a Candida Auris infection, alert your local state department of health in case they do not already know. (Nursing homes should be doing this but we believe some may not be following the rules.) You may also have important legal rights. One attorney was recently quoted as saying patients can sue a nursing home if improper staffing or sanitation was the cause of the Candida Auris infection.