LAS VEGAS (KLAS) — Medical practices are facing a difficult problem as tests reveal an increasing number of cases linked to the “superbug” known as Candida auris. Are people dying “of” C. auris or just “with” C. auris?
That’s an uncomfortable question. As a result, the Nevada Department of Public Health Behavior (DPBH) no longer releases data on deaths involving one of the CDC’s five “superbugs” classified as urgent health threats. The last time the CDC released case numbers by state, Nevada accounted for 14% of the U.S. cases.
In November 2022, 8 News Now reported DPBH statistics showing 63 deaths related to C. auris. Our report states in the second paragraph that “the deaths were not necessarily caused by the fungus.” However, this is the last time we can report information about a death. Data released in March 2023, November 2023, and February 2024 do not include information on deaths.
When asked about information on C. auris deaths three months ago, DPBH replied:
In April 2022, the Department of Public Behavioral Health (DPBH) asked health care facilities to report cases of C. auris to state healthcare-associated infectious disease programs. DPBH previously compiled the number of deaths from reported C. auris cases. However, patients infected with C. auris often have additional serious medical conditions that increase their risk of death. It is very difficult to determine whether the death of such patients was due solely to C. auris and not to a pre-existing disease. Additionally, there is no national case definition for C. auris deaths. Therefore, it was decided to discontinue reporting the number of deaths in C. auris patients, as such reporting was found to be inaccurate and unfeasible at this time.
The current total number of cases is nearly four times as high as the last time DPBH provided information on deaths. The number of cases has increased from 774 in November 2022 to 2,870 now. However, there is no data on mortality.
“There may be some hesitation among people who are dealing with this disease in hospital facilities and state health departments because this is such a huge challenge,” Dr. Neil Clancy told 8 News Now . Clancy is an infectious disease expert and professor of medicine at the University of Pittsburgh.
And Clancy says the number of deaths is not important in understanding the seriousness of C. auris.
“The most important thing is to know how many cases and how many colonizers we are detecting, because that tells us how much it is out there and how much it is being detected,” he said. .
“Honestly, for me as a physician and infectious disease specialist, the mortality numbers are probably not that important because, as I said, when you get this type of infection or this type of infection, “It’s very difficult for patients who are suffering from infection to understand how much Candida auris actually contributes to endpoints such as death for all that is happening medically.” “We need to know,” Clancy said.
Why is it so difficult to determine how a patient died?
Clancy said people diagnosed with C. auris infections often have serious underlying health conditions that make them more susceptible to the infection. “So in individual cases, it is often very difficult to know whether people are dying ‘due to’ or ‘associated with’ a candida infection.” he said.
“Is Candida contributing to the death in half of the patients? Is it less? Or more? As you know, it’s very difficult to put a precise bead on this.” Clancy said. But his research can help find the answer.
“If you look at all Candida infections, 20 to 40 percent of patients who have deep infections, regardless of Candida species, the mortality rate is usually around 20 to 40 percent,” he said. But he stressed that this statistic only pertains to deep infections, not skin or vaginal infections, which are common.
DPBH data do not include the level of clinical case detail needed to estimate the number of deaths caused by C. auris.
“I think it’s important for the public to be aware of this type of thing,” Clancy said. “Likewise, I don’t think they should be so afraid that they should not seek medical care, should not go to the hospital, should not receive what they need” done for their health and well-being. It is. ”
Clancy directs the mycology program at the University of Pittsburgh. C. auris has been getting more and more attention lately, but it’s not the only fungal infection to make the news. He said there are many factors contributing to the spread of infectious diseases, including climate change and agricultural practices.
Research continues, including research into how bacteria and fungi interact within the human body.
“We all carry millions of bacteria and fungi in our bodies, most notably in our intestines, our digestive tracts. So we carry these huge burdens. If they persist, they become what we call “resident flora.” But they become a problem when they get into places they shouldn’t be, such as the bloodstream or other normally sterile tissue sites,” Clancy said.
