from the editor
An Insidious Foe Becomes Entrenched in Hospitals
While we had our backs turned to fight SARS-CoV-2 , other opportunistic pathogens took advantage of our preoccupation with COVID to become more entrenched in healthcare facilities , as researchers have documented in several studies the past year or so , including Lastinger , et al . ( 2022 ) that indicated “ Increases in healthcare-associated infections ( HAIs ) and device utilization were observed throughout 2020 as hospitals responded to increased patient volumes , increased patient acuity levels and comorbidities , and staffing and supply shortages .”
Data from the Centers for Disease Control and Prevention ( CDC ) published in the Annals of Internal Medicine late last month suggest that Candida auris ( C . auris ), an emerging fungus considered an urgent antimicrobial resistance ( AR ) threat , “ spread at an alarming rate in U . S . healthcare facilities in 2020-2021 .” Equally concerning , according to researchers , was a tripling in 2021 of the number of cases that were resistant to echinocandins , the antifungal medicine most recommended for treatment of C . auris infections . The CDC has deemed C . auris as an urgent AR threat because it is often resistant to multiple antifungal drugs , spreads easily in healthcare facilities , and can cause severe infections with high death rates .
“ The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance , expanded lab capacity , quicker diagnostic tests , and adherence to proven infection prevention and control ,” says CDC epidemiologist Meghan Lyman , MD , lead author of the paper ( Lyman , et al . 2023 ).
Since it was first reported in 2016 , there have been a total of 3,270 clinical cases of C . auris infection and 7,413 screening cases ( in which the fungus is detected but not causing infection ) reported through Dec . 31 , 2021 . Clinical cases have increased each year since 2016 , with the most rapid rise occurring 2020- 2021 . CDC has continued to see an increase in case counts for 2022 . During 2019-2021 , 17 states identified their first C . auris case ever . Nationwide , clinical cases rose from 476 in 2019 to 1,471 in 2021 . Screening cases tripled from 2020 to 2021 , for a total of 4,041 . Screening is important to prevent spread by identifying patients carrying the fungus so that infection prevention controls can be used .
Experts say C . auris case counts have increased for many reasons , including poor general infection prevention and control practices in healthcare facilities . Case counts may also have increased because of enhanced efforts to detect cases , including increased colonization screening , a test to see if someone has the fungus somewhere on their body but does not have an infection or symptoms of infection . The timing of this increase and findings from public health investigations suggest C . auris spread may have worsened due to strain on healthcare and public health systems during the COVID-19 pandemic , experts emphasize .
The CDC says it continues to work with state , local , and territorial health departments and other partners to address this emerging threat to public health , but the real work remains in the healthcare environment , requiring adequate resourcing for education and training , properly equipped , staff and resourced environmental services ( EVS ) departments , and awareness on the part of all healthcare personnel about the role they play in combatting C . auris acquisition and infections .
Until next month , bust those bugs ! Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com
References :
Lastinger LM , et al . Continued increases in the incidence of healthcare-associated infection ( HAI ) during the second year of the coronavirus disease 2019 ( COVID-19 ) pandemic . Infect Control Hosp Epidemiol . Published online May 2022 . DOI :
https :// doi . org / 10.1017 / ice . 2022.116
Lyman M , et al . Worsening Spread of Candida auris in the United States , 2019 to 2021 . Ann Intern Med . March 21 , 2023 . DOI : 10.7326 / M22-3469 healthcarehygienemagazine
editor & publisher
president & cfo art director customer service manager
Kelly M . Pyrek kelly @ healthcarehygienemagazine . com
A . G . Hettinger , CPA Patti Valdez J . Christine Phillips
Healthcare Hygiene magazine is published monthly by Keystone Media Inc . 8955 Ridgeline Blvd ., Suite 500 , Highlands Ranch , CO 80129 . Free digital subscriptions available at www . healthcarehygienemagazine . com for U . S ., Canada and other foreign subscribers . Copyright © 2023 Keystone Media Inc . All rights reserved . The publisher reserves the right to accept or reject any advertising or editorial material . Advertisers , and / or their agents , assume the responsibility for all content of published advertisements and assume responsibility for any claims against the publisher based on the advertisement . Editorial contributors assume responsibility for their published works and assume responsibility for any claims against the publisher based on the published work . All items submitted to Healthcare Hygiene magazine become the sole property of Keystone Media Inc . Editorial content may not necessarily reflect the views of the publisher . No part of this publication may be reproduced in any form or by any electronic or mechanical means , including information storage and retrieval systems , without permission in writing from the publisher .