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The Candida auris fungusOn September 11, 2019 the New York Times published an  article entitled “Nursing Homes are a Breeding Ground for Fatal Fungus”, written by Matt Richtel and Andrew Jacobs which reveals a serious health threat to nursing home residents. The article discusses concerns over a highly contagious, drug-resistant germ affecting ill nursing home patients. According to the article, Candida auris, a drug-resistant fungus, arrived in the United States four years ago.  Since that time, nearly 800 people have been infected – half dying within 90 days.

The article focuses on a skilled nursing facility in Brooklyn, NY and tells the story of a 65 year old patient diagnosed with Candida auris.  The patient, suffering from a long list of ailments, is one among at least 38 other patients residing at the same nursing home who have been infected with, or carry, C. auris.  Public health officials state that skilled nursing facilities are fueling the spread of this hard to eradicate pathogen.

According to the article, blame for the rise in drug-resistant infections like C. auris, is due to the overuse of antibiotics in humans and livestock. In addition, public health experts believe that long-term hospitals and nursing home facilities are a weak link in the health care system because they are often  understaffed and ill-equipped  to enforce rigorous infection control practices. A recent inquiry by the New York State Department of Health reportedly found that some long-term care facilities dealing with C. auris are not taking proper measures such as using disposable gowns and latex gloves or clearly marking the rooms of infected patients.  Infected patients who carry C. auris are being repeatedly cycled into hospitals and back to the nursing home raising the risk of infecting others in both settings.

The Article states, “The story is far bigger than one nursing home or one germ. Drug-resistant germs of all types thrive in such settings where severely ill and ventilated patients … are prone to infection and often take multiple antibiotics, which can spur drug resistance. Resistant germs can then move from bed to bed, or from patient to family or staff, and then to hospitals and the public because of lax hygiene and poor staffing.”

If your loved one is in a nursing home, we recommend that you ask the attending physician, charge nurse and social worker which infection control processes are in place and carefully observe whether they are followed. Ask whether the care plan includes infection control processes.  Learn how staff will be notified that infection control processes are needed.  Question how staff are monitored to ensure that infection control processes are followed.  Insist that caregivers wash their hands before caring for your loved one. Gloving, gowning and masking may be appropriate if your loved one has a compromised immune system. Report any violations that you see to a supervisor or administrator in writing.  Question whether any roommate, particularly one that is returning from a hospital stay, has any infectious condition that could be transferred. Ask your loved one if the infection control processes are followed when you are not there to observe.

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