‘Superbug’ cases climb to 600 in southern Nevada

Cases of once-rare “superbug” Candida auris have climbed to 600 in southern Nevada, with more than one-third identified at just two hospitals.

Sunrise Hospital and Medical Center, the largest general acute-care hospital in the state, has reported 122 cases of the drug-resistant fungus, the most of any hospital or skilled nursing facility. The first pediatric cluster of C. auris cases in the U.S. was identified at the Las Vegas hospital in May.

Horizon Specialty Hospital — Las Vegas reported 95, the second-highest number, according to state data as of Oct. 24. Thirty-three medical facilities have now reported cases.

C. auris can cause bloodstream infections and even death, particularly in hospital and nursing home patients with serious medical problems. More than one in three patients die after developing an invasive infection, such as one affecting the blood, heart or brain, according to the Centers for Disease Control and Prevention.

As of Nov. 18, 63 deaths had been reported in patients with C. auris, state health officials said. The first cases ever identified in Nevada were reported in August of last year.

Rounding out the five facilities reporting the most cases are Horizon Specialty Hospital of Henderson with 59 cases, Valley Hospital Medical Center with 38, and Silver Ridge Health Center with 32, according to Nevada Department of Health and Human Services data.

A higher number of cases at a facility “doesn’t always mean there’s a problem with infection control,” said Kimisha Causey with the Nevada State Healthcare Associated Infection Program. The facility reporting a case may not be the place where the patient acquired it, she said, noting that patients transfer among facilities.

She acknowledged about higher case numbers, however, “From a consumer standpoint, to me it would be concerning.”

Hospitals said some of the cases they are reporting are those they identify through screening patients upon admission.

“With a focus on heightened surveillance testing, we continue to identify patients upon admission,” said Dr. Steven Merta, chief medical officer for Sunrise Hospital. “We continue to practice targeted testing, enhanced isolation, high-level cleaning practices and advanced infection prevention technologies to keep our patients, colleagues and visitors safe.”

Gretchen Papez, a representative of Valley Health System hospitals including Valley Hospital, said their hospitals “remain vigilant in the detection and treatment of C. auris through screening, testing, treatment, isolation protocols and room disinfection processes with deep cleaning and UV-C lights.”

Horizon Specialty Hospitals and other facilities reporting relatively high case numbers did not respond to requests for comment.

Genetic analysis of cases indicates that there are two separate outbreaks of C. auris in Southern Nevada, each with a different clade, or strain, of the fungus, said Mark Pandori, director of the Nevada State Public Health Laboratory in Reno.

It appears that two facilities were struck by different strains of the fungus, which then spread to other facilities, Pandori said.

These facilities were Sunrise and Centennial Hills Hospital Medical Center, Shannon Litz, a health department public information officer, said last week.

With cases mounting, the state health department in April launched an investigation. The CDC sent a team to assist with the outbreaks, including with assessing facility infection control practices and educating staff on the new pathogen and how to prevent its spread.

The basics: C. auris is highly transmissible. It spreads through contact with contaminated surfaces. It also spreads from person to person. It spreads from facility to facility through patients and potentially staff.

The proper use of personal protection equipment, including gloves and gowns, and of other infection-control procedures, from basic hand-washing to high-tech cleaning protocols, can curb its spread.

People most likely to become infected with C. auris are those who have been hospitalized in a health care facility for a long time, have a central venous catheter or other lines or tubes entering their body, the CDC said.

Based on CDC guidance, the Nevada health department recommends that facilities screen new patients for C. auris upon admission. It also recommends that patients again be tested if their roommate or another patient in their unit tests positive, Causey said.