Emerging Antibiotic-Resistant Infections in Nursing Facilities Setting Off Alarms
Emerging antibiotic-resistant infections are causing new concerns, as the Centers for Disease Control and Prevention (CDC) has identified nursing facility patients with anti-fungal resistant Candida auris yeast infections. Of 101 infected residents, the agency reported, three were identified as being resistant to all three drug classes known to treat the yeast infection.
While the infections were unresponsive to azoles, amphotericin B, and echinocandins, the CDC reported, it is the latter that is causing the greatest concern. Echinocandins are considered a critical defense against C. auris infections and traditionally is effective in about 99% of cases. The infection fails to respond to the other two drugs much more frequently.
Candida auris is highly contagious and can spread rapidly, according to CDC. About 5% to 10% of colonized patients are likely to develop invasive infections, and up to 60% of these result in death. The fungus can grow on intravenous lines and ventilators, which is of particular concern in nursing facilities that care for ventilated residents. Candida auris is hard to eradicate, as it can colonize on the skin and spread quickly. It has been found on multiple surfaces in infected patients’ room; and it can linger even after thorough cleaning.
The CDC offered infection control recommendations for prevention of C. auris transmission in healthcare settings. These include:
- Adherence to hand hygiene
- Appropriate use of transmission-based precautions based on setting
- Cleaning and disinfecting the resident care environment (daily and terminal cleaning) and reusable equipment with recommended products
- Inter-facility communication about patients’ auris status when patients are transferred to another healthcare facility
- Screening contacts of newly identified case patients to identify auris colonization
- Laboratory surveillance of clinical specimens to detect additional cases
“Time is of the essence because we may soon run out of options to treat infected patients,” according to a recent statement released by the Association for Professionals in Infection Control and Epidemiology (APIC). Prevention is the best strategy for managing multidrug-resistant C. auris infections in nursing homes and hospitals, according to APIC.
For information on infection control and prevention of C. auris, read here.
Click here to download a tip sheet with infection control recommendations for prevention of C. auris transmission in healthcare settings.