Updated May 20, 2022 - 6:25 pm
The state health department late Thursday identified 19 hospitals and skilled-nursing facilities in Southern Nevada with recent reported cases of a drug-resistant “superbug” that can result in serious illness and even death.
The Nevada Department of Health and Human Services did not specify which facilities had experienced outbreaks of the Candida auris fungus, nor did it specify how many cases had been identified at each facility.
“There are no determined outbreaks at any facility currently,” department representative Dawn Cribb said in an email Friday.
Some facilities disputed that they had experienced a case.
The department disclosed there have been 14 deaths in patients, “but it is unclear at this time if the deaths occurred due to the patient having a C. auris infection or other medical conditions,” Cribb said.
The health department launched an investigation of outbreaks of C. auris in mid-April. The Centers for Disease Control and Prevention has deployed a team that has been at health care facilities this past week assisting with the investigation.
The teams are investigating 12 of the 19 facilities, Cribb said. She did not specify which ones.
C. auris, which spreads easily through contact with contaminated surfaces, can cause bloodstream infections and even death, particularly in hospital and nursing home patients with serious medical problems. More than 1 in 3 patients die who have an invasive C. auris infection, such as one affecting the blood, heart or brain, according to the CDC.
In the U.S., C. auris infection has primarily been identified in people with serious underlying medical conditions who have received multiple antibiotics, and who have had prolonged admissions to health care settings or reside in health care settings, the CDC states.
The state’s list of facilities, provided in response to requests from the Las Vegas Review-Journal, includes 10 acute-care general hospitals: Centennial Hills; Desert Springs; Henderson; MountainView; Spring Valley; Summerlin; Sunrise; University Medical Center; and Valley hospitals.
Late Friday, the state corrected its list to include St. Rose Dominican, Siena campus, instead of the San Martin campus. St. Rose spokesman Gordon Absher said late Thursday one case had been identified at the Siena campus in March.
A representative of the Valley Health System said the hospital group responded immediately to the threat of the fungus.
“As soon as we became aware of the presence of Candida auris (C. auris), we began taking immediate precautions with surveillance and/or culture testing, patient safety processes, and enhanced cleaning protocols,” representative Gretchen Papez said in an email.
“The Valley Health System hospitals use enhanced cleaning protocols when a patient who was in isolation is discharged (i.e. patients with superbugs). Those rooms and equipment are disinfected using bleach and ultraviolet light technology.”
All six of the hospitals in the Valley Health System, the largest hospital group in Southern Nevada, are on the list.
A representative of UMC said this week that the county hospital had identified a “cluster” of cases and that it was guiding its clinicians “through the necessary infection control procedures to maintain the health and safety of our patients and caregivers.”
A representative of the Sunrise Health System, whose Sunrise and MountainView hospitals have reported cases, previously said that the hospital group “continues to work with the Nevada Department of Health and Human Services and the CDC on understanding and addressing this emerging disease across Las Vegas healthcare settings.”
Specialty hospitals, skilled nursing facilities identified
The state also identified four specialty hospitals as having reported cases: Horizon Specialty-Henderson; Horizon Specialty-Las Vegas; Kindred Flamingo; and Kindred Sahara.
And it identified several skilled nursing facilities: College Park Rehab; Kindred Flamingo; Silver Hills Healthcare Center; Silver Ridge Healthcare; and St. Joseph Rehab.
A fifth skilled nursing facility on the list, Silver Hills Healthcare Center, has not had any known cases of C. auris, said Kerry Laviolette, executive director of the skilled nursing and rehabilitation center.
A patient who spent two days at the facility after transferring from an acute-care facility on the state’s list of hospitals with C. auris tested positive at least 30 days after discharge from Silver Hills, Laviolette said.
“It makes no sense why our facility was on there,” he said.
Cribb said facilities on the list “have been identified with reported C. auris cases.”
The Kindred hospitals and skilled-nursing center have “no actively infected patients,” said Bud Schawl, CEO of Kindred hospitals in the Las Vegas market.
Kindred is testing all patients upon admission and routinely screening high-risk patients, he said in an emailed statement.
“We recognize that our critically and chronically ill patients are most at-risk and their safety is paramount,” he said. “We follow all infection control protocols for those patients who have been colonized with C. auris and are ready for those patients suffering from an active infection.”
College Park Rehab administrator Julie Liebo said in an emailed statement, “While we are disappointed that Candida auris was found in our facility, we are confident that the infection Prevention and Control Measures we have (been) diligently practicing over the past two years will help us keep these infections to a minimum.
“We are working closely with our state and local officials and following their recommendations and guidance.”
Other facilities did not respond to requests for comment.
‘Where did it come from?’
Once rare, C. auris infection has become more common. Infections are resistant to multiple drugs typically used to treat Candida infections, with some strains resistant to all types of antifungals.
In 2021, there were nearly 1,300 reported confirmed or probable cases of C. auris in the U.S. , according to CDC data, with cases in the low triple figures in California, Florida, Illinois and New York. Nevada had two reported cases last year.
From Jan. 3 to Monday, 73 clinical cases of C. auris were identified in Southern Nevada and 92 cases in which the individuals were “colonized” with the fungus but did not have an active infection, according to the state health department. Colonized individuals have no symptoms of infection but have the fungus somewhere on their bodies, allowing them to unknowingly spread the disease.
One the fungus is introduced into a facility, it can spread quickly through contact with surfaces.
Candida auris is a “very resilient, persistent organism,” living on surfaces and skin for lengthy periods, said David Perlin, chief scientific officer of the Center for Discovery and Innovation and a professor at the Hackensack Meridian School of Medicine.
It has been known to spread within a facility when a colonized individual touches a patient’s bed rail, which is then touched by a doctor, said Perlin, an authority on C. auris.
The fungus may spread between facilities when an infected patient is transferred from a hospital, for example, to a nursing facility, he said.
But much about C. auris outbreaks remains a mystery.
“You basically had no infections in Nevada,” Perlin said. “Now all of a sudden you have a major outbreak. The question is, where did it come from to begin with?”