Deadly fungus spreading at 'alarming rate, 'CDC says; New York cases up 83% since pandemic

A deadly fungus that is resistant to drugs spread at an “alarming rate” at health care facilities during the first year of the COVID-19 pandemic, according to new data from the Centers for Disease Control and Prevention.324

Candida auris, also known as C. auris, is a type of yeast that can enter the bloodstream and spread throughout the body, resulting in serious invasive infections, the agency said.

The number of clinical cases in New York has increased 83% since the pandemic, from 178 in 2019 to 250 in 2020, 283 in 2021 and 326 in 2022, according to data on the CDC website. 

The fungus is often resistant to antifungal drugs, spreads easily in health care facilities, and can cause severe infections with high death rates, according to the report.

While not usually harmful to healthy individuals, it can be deadly for fragile hospital and nursing home patients.

Nationally, clinical cases of C. auris increased from 476 in 2019 to 1,471 in 2021, federal statistics show. Screening cases, in which the patient is found to be carrying the organism but not showing signs of active infection, tripled from 2020 to 2021 to 4,041, according to the report in the Annals of Internal Medicine, an academic journal.

The authors also noted that screening for C. auris varies across the U.S. and cases may go undetected, underestimating the problem.

“In general, C. auris is not a threat to healthy people,” the CDC said in a statement. “People who are very sick, have invasive medical devices, or have long or frequent stays in health care facilities are at increased risk for acquiring C. auris.”

Researchers said the C. auris spread may have been “exacerbated” by the COVID-19 pandemic’s strain on health care, which included staff and equipment shortages as well as an increased number of patients, especially those who were severely ill.

For example, the report said, extended use or reuse of personal protective equipment or inappropriate use of multiple gowns and gloves at once could have contributed to the spread.

Dr. Luis Ostrosky, chief of infectious diseases and epidemiology with UTHealth Houston and Memorial Hermann, said at the start of the pandemic there was a decline in hospital-associated infections but as facilities were forced to deal with more patients and fewer staffers, they started to rise.

“Once it started to spread very fast in the long-term care setting it’s stealthily moving to acute care and that is what we are seeing in this report,” he said.

C. auris is able to grow on the skin and nasal cavities of caregivers, as well as surfaces of equipment and furniture at health care facilities, Darin Wiesner, assistant professor at Rutgers New Jersey Medical School, at the Center for Immunity and Inflammation, told Newsday in an email.

“At risk populations congregate at health care facilities, C. auris tends to accumulate in areas that are frequented by sick patients, and the cycle repeats,” he said.

Currently, there are only three classes of antifungal drugs, he said, adding that C. auris is completely resistant to one of them, known as azoles, and is evolving resistance to the others, polyenes and echinocandins.

Ostrosky said overuse of antibiotics and antifungal medications is likely one reason why these pathogens are becoming more drug resistant. Some of them are also better able to adapt to the environment and thrive in different temperature settings.

“I think it’s extremely alarming,” said Richard Mollot, executive director of the Long Term Care Community Coalition, which advocates for people in nursing homes and long-term care facilities.
Mollot said he said it feels like nursing home residents “have a target on their back" because they are most likely to become seriously ill and die from this fungus.

Dr. David Hirschwerk, medical director at North Shore University Hospital in Manhasset, said the facility sees about one or two cases of C. auris a month but remains vigilant.

“It’s still relatively rare but we're always on the lookout for it,” he said. “We do have an intensified protocol to reduce the risk of spread throughout the hospital, and that has been very successful.”

Those measures include communication among staff members, specialized cleaning of rooms that the patient has been in as well as precautions for the use of gowns.

Researchers said faster and more accessible testing, improved disinfection methods and new antifungal drugs are needed to both reduce the spread of C. auris and be better prepared for future epidemics.

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.