A 36-bed specialty recovery hospital that operates on the seventh floor of DMC Sinai-Grace Hospital in Detroit is no longer admitting new patients because of an outbreak of a drug-resistant, highly contagious and often deadly fungal infection called Candida auris.
Select Specialty Hospital – Northwest Detroit is voluntarily pausing admission of new patients as it works with the state health department and the city of Detroit’s health department to address the outbreak.
Fifteen cases of Candida auris have been detected in Michigan since 2021 — seven of which have been identified in the last five weeks in patients at Select Specialty Hospital – Northwest Detroit. Prior to 2021, there had been no known cases of C. auris in Michigan in at least five years.
Candida auris can spread through health care facilities, through contact with contaminated surfaces or equipment and can cause serious illness and death, especially among elderly people, those with underlying medical conditions and people who live in nursing homes. Antifungal medications often used to treat yeast infections typically don’t work against Candida auris.
When it gets into the bloodstream, it is deadly in 1 in 3 people.
“In the demographic that’s a greatest risk … those folks have up to an 80% mortality rate,” Dr. Russell Faust, medical director for the Oakland County Health Division told the Free Press for an article published in 2021 about Candida auris.
“I look at this as potentially our Ebola. So we need to be very, very cautious when we’re talking about C. auris. We know it’s here. It’s in Canada. It’s in Illinois to the west of us. It’s in New York to the east of us. It’s south of us, in those states. So we know it’s here and we know it’s now in Michigan.”
Those at highest risk for death from the fungal infection, Faust said, are people who have a tracheotomy, gastrostomy, central catheters, long-term IVs or catheters, those who are on ventilators and anybody who is elderly and has been on multiple antibiotics or antifungals as well as people who have had multiple health care stays especially at long-term care facilities.
As of Wednesday, none of the 15 people with cases identified in Michigan in the last year have died.
“The Detroit Health Department is working with the Michigan Department of Health and Human Services and Detroit-area hospitals to prevent the spread of C. auris, which poses a health risk to hospital patients with weakened immune systems,” said Denise Fair Razo, the city of Detroit’s chief public health officer in a statement.
“We will provide epidemiology tracking and support to Detroit area hospitals to make sure staff have protocols in place to stop the spread of this organism and protect patients.”
Health officials are working to identify and screen people who have been discharged from Select Specialty Hospital – Northwest Detroit since March 1. No additional cases have been found at this time.
Select Specialty is educating health care workers, patients and their families about C. auris, is beefing up hand hygiene practices, use of personal protective equipment, and deep cleaning of high-touch surfaces. It also has adopted the following protocols:
- Screening all patients for C. auris prior to discharge and notifying any facility accepting a patient from Select Specialty of the C. auris outbreak and the results of the patient’s screening.
- Conducting hospital-wide C. auris screening of all patients at least once every two weeks.
- Allowing MDHHS and cooperating public health agencies, including the local health department and the Centers for Disease Control and Prevention, to conduct a public health investigation.
Candida auris was first identified in 2009 in Japan. It wasn’t until June 2016 that the CDC began requiring health care providers to report it.
Since 2016, the number of infections has grown around the world, and Candida auris is now considered a serious global public health threat.
As of Wednesday, no Candida auris infections have been identified at Sinai-Grace Hospital, said Detroit Medical Center CEO Brittany Lavis.
“Sinai-Grace Hospital has extensive and rigorous infection-prevention protocols in place to ensure all hospital services remain safe and available to care for the community,” she said in a statement. “We have not identified any Sinai-Grace Hospital patients who have tested positive for C. auris. We are fully cooperating with the department and support the decision to pause patient admissions at the Select Specialty Hospital-Northwest Detroit.”
Several steps should be taken to rein in the spread of Candida auris, Faust said. Among them:
- People should seek medical care for any wound that is not healing as it should. Don’t delay care.
- Doctors and medical providers should avoid prescribing unnecessary antibiotics and anti-fungal treatments.
- More investment should be made in the instruments and technology needed to diagnose it.
“We really need to develop our ability at containment so that when these do pop up, we diagnose them more rapidly,” he said.
Contact Kristen Jordan Shamus: firstname.lastname@example.org. Follow her on Twitter @kristenshamus.