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2 Collin County hospitals grapple with ‘superbug’ fungus outbreaks that have killed 4, officials say - The Dallas Morning News

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Officials confirmed Friday that two Dallas-area hospitals that are grappling with outbreaks of an untreatable fungus are in Collin County and that four patients who became infected with the “superbug” at the facilities have died.

State and local officials confirmed to The Dallas Morning News that there was evidence of the “superbug” fungus, Candida auris, in two hospitals in the county. The Centers for Disease Control and Prevention had described the outbreaks in a report Thursday as untreatable fungus spreading in “two Dallas-area hospitals.”

Chris Van Deusen, a spokesman for the Texas Department of State Health Services, said Collin County is “leading the investigation” into the fungus. Officials declined to provide additional information about the two facilities.

Collin County officials released information about the fungus hours after The News’ inquiries. The news release confirmed that two health-care facilities in the county had seen cases of the drug-resistant variants and that four patients had died after becoming infected.

The News contacted 12 hospitals and health systems in the county to ask about the fungus. Most did not respond. One, the Life Care Center of Plano, said it has seen no indication of the organism.

Andy Wilson, a spokesman for Texas Health, which operates at least four health centers in the county, said “we aren’t currently granting interviews on this topic.”

An emerging infectious disease

Candida auris is a harmful form of yeast that is considered dangerous to hospital and nursing home patients with serious medical problems. It is most deadly when it enters the bloodstream, heart or brain.

More than one in three patients with invasive C. auris infections die, the CDC says. The fungus, which was discovered in 2009, has spread quickly and has been found in a dozen nations.

The CDC said that a cluster of 22 patients in the Dallas-area hospitals included two who were resistant to all three major classes of antifungal medications. Both those patients died.

The cases in the Dallas area — as well as a cluster in a Washington, D.C., nursing home — were seen from January to April, the CDC said. It reported that both are ongoing outbreaks and that additional infections have been identified since April. But those added numbers were not reported.

Experts told The News that the fungus primarily affects people who are severely immunocompromised or elderly. Outbreaks in health-care facilities have been spurred when the fungus spread through patient contact or on contaminated surfaces.

Symptoms of invasive Candida infection are fever and chills that don’t respond to antibiotics. But only a lab test can diagnose the infection.

Dr. Meghan Lyman of the CDC had said this is “really the first time we’ve started seeing clustering of resistance” in which patients seemed to be getting the infections from each other.

“While we’ve only seen a small number of cases, it’s likely that there are more cases not being identified,” she said in a written statement provided to The News. “At present at least 10 cases were identified in two states that were either resistant to first-line treatment or resistant to all available treatment options.

“We are urging health-care facilities to take proactive steps to identify and prevent spread of this fungus so that it does not gain a foothold in their patient population,” she added.

Van Deusen said Texas issued a health advisory on March 16 that notified health care providers of two pan-resistant infections — meaning those that are resistant to nearly all classes of anti-fungal drugs — from January and February. He said no additional pan-resistant cases have been identified in the state.

“DSHS worked with Collin County Health Care Services ... to provide support, including visits to evaluate infection control practices and testing of people who may have been exposed,” Van Deusen said.

After receiving The News’ inquiries, Collin County reported that two patients at the facilities were infected with the fungus’ pan-resistant variant, including one who died. Seven other patients were infected with the echinocandin-resistant strain, and three of those patients died.

County officials did not specify when the cases happened but said the outbreaks happened “recently.” They said the untreatable fungus had “became reportable” in Texas on Jan. 5.

‘A critical time’

Dr. Luis Ostrosky, a professor and the chief of infectious diseases at the McGovern Medical School at UTHealth in Houston, said he was concerned to see that the fungus had been detected in Texas since there’s “so much exchange” of patients between hospitals, nursing homes and long-term care facilities.

He said the organism is worrisome because it’s resistant to common anti-fungals and spreads in a pattern not seen before in yeasts since it transmits within the hospitals, rather than coming from a person’s own body.

“It’s very easy for it to really take foothold of a place and cause outbreaks and transmit it to other places, etc.,” Ostrosky said. “So if anything I’m surprised it hasn’t happened before up to now.”

Ostrosky said there’s hope on the horizon for new anti-fungals that are effective, but he noted the outbreaks serve as a reminder of the need to continually invest in development of new antimicrobials.

“Now is kind of a critical time where if we don’t actively look for it and are very aware of it and isolate and know what to do when we have a patient, we are going to be spreading it to more and more facilities,” he said.

He added that officials may be reluctant to name the facilities with an outbreak out of concern that people may avoid going there when they’re in need of care.

“It causes a lot of damage to the facility when they may have a contained outbreak,” Ostrosky said. “So I know that the policies for many of the public health agencies is not to identify facilities by name.”

Dr. Lawrence Muscarella, an infection control expert, said he disagrees with the belief that the public can’t do anything with the information.

He said that the CDC has identified the locations of other outbreaks, such as with COVID-19. Inconsistencies in those policies could create mistrust and a reluctance to follow public health guidelines, he added.

“My alarms bells sounded because a delay in alerting the public to this risk – which we only just learned about — can be problematic and pose safety risks to the public,” he said. “I am wondering why we were not notified about this fungus’ spread at these facilities several weeks ago.”

Muscarella said patients who might be concerned should ask their physician about any outbreaks or clusters at the facility.

“If my physician’s answer is suitable, I would feel comfortable, trusting and proceed without losing sleep,” he said. “But if the answers to my questions seem vague as unlikely as this may be, I would select another facility for my procedure.

“Under no circumstances, however, would I cancel the procedure,” he said. “I would just select another more suitable, nearby and reputable facility for it to be performed. In general, when you ask questions, your safety increases.”

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