New research on a frightening new superbug confirms what scientists have both suspected and feared: Some hospitalized patients who carry the fungus shed large amounts of it from their skin, contaminating the environment in which they are being treated and leaving enough of it to infect others later on.

The bug, called Candida auris, is highly resistant to many existing antifungal drugs. It’s also resistant to regular cleaning methods, making hospital outbreaks incredibly difficult to stop.

C. auris acts more like bacteria than fungi, which do not normally cause hospital outbreaks. Its relatively recent emergence as a hospital-acquired infection has researchers scrambling to find out even the most basic information about it, like how it moves from patient to patient.

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The new work was conducted by scientists from the Centers for Disease Control and Prevention in conjunction with colleagues from the Chicago Department of Public Health. It was presented Sunday at the annual conference of the American Society for Microbiology in San Francisco.

“As we’re struggling to control this organism, the reality is we don’t know how it’s spreading from person to person. We know that it does. But mechanistically we don’t know how. And so what this study was about was trying to identify the mechanism of how it can get from one person to the other,” said Joseph Sexton, a scientist with the CDC and the lead author of the work. “If we don’t understand how it spreads, we’re not going to be able to intervene.”

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Before members of the team could conduct the study, they had to figure out a way to quantify how much of the fungus was present in any one place — a basic step in studying many pathogens, but not easy to do with C. auris, said Johanna Rhodes, an epidemiologist at Imperial College London. Rhodes, who studies C. auris, was not involved in the CDC research.

“A lot of us have been scratching our heads as to how the heck do you do this?” Rhodes said of the task of trying to devise a way to quantify amounts of the fungus. “It doesn’t have the standard set of genes that you would expect to find. It’s just such a weird bug.”

She was excited to learn of the CDC’s work — both the development of the quantification methods and the findings of the study on transmission of C. auris. Lots of people studying the fungus have assumed what the CDC team found, but it’s critical to actually have data, she said.

“We’ve all kind of said, ‘Yeah, we think this is it. We think this is what happens.’ [But] they’ve done the work,” said Rhodes. “It’s fundamental in our understanding of how this is actually spreading.”

The superbugs are growing in strength and it’s our fault. Hyacinth Empinado/STAT

The CDC and Chicago scientists studied 28 patients in an outbreak in what is called a ventilator-capable skilled nursing facility in Chicago. Facilities like these offer long-term care to very sick patients who are typically on ventilators, machines that breath for them. These are patients who are bed-bound.

The facility first discovered a patient carrying C. auris in March 2017. But by the time the study was done, 71% of the patients on the floor where ventilated patients are cared for were colonized with C. auris — meaning they carried it on their skin.

C. auris is an infection that is associated with patients with complex medical problems and compromised immune systems; it is generally not considered a risk to the average healthy person. But it can significantly complicate the care of people who are in intensive care units or other areas of hospitals that involve advanced care. About a third of patients who have tested positive for C. auris die, though it’s sometimes unclear if the infection was the cause of death.

The CDC-led team took skin swabs from 28 patients in the Chicago facility, swabbing their armpits and groins, which are among the places bugs that live on human bodies are often found.

They also tested a variety of surfaces in patient rooms — bed railings, doorknobs, and windowsills.

Their hypothesis was that if patient shedding was responsible for spread, they would find more of the fungus in the rooms of patients who had more of it on their skin. And indeed, they found the rooms inhabited by patients with lots of C. auris on their skin were the most contaminated with the fungus.

All of the railings on beds housing patients with C. auris tested positive for the fungus. Even the railings of two beds that contained patients who didn’t have C. auris were contaminated. Sexton said study of the patient flow on the ward revealed the beds had previously been inhabited by patients who were C. auris-positive. “So we know that they’re not doing a good enough job disinfecting the bed,” he said.

Surprisingly, three-quarters of the windowsills were also contaminated with the fungus. That was unexpected — until the team realized that windowsills were used as de facto shelves in these rooms.

“If there is a takeaway it could be …. ‘Hey, we really need to pay attention to the bed and these other areas that the patient is in contact with,’” said Sexton.

  • PLEASE DO YOUR BEST TO HELP ME! I have been suffering so since strange and horrific things began happening to my body and my home approximately one year ago.. Now myself, my home And my dog are heavily infected with this. The manifestations of this powerful resistant fungus are affecting my body with heavy colonization of some kind of white, comma shaped crap, what I presume to be a yeast, just beneath my skin, and it is spreading quickly. From all of the research I have done, this monster is actually producing a protective layer of something on top of my skin and is hiding underneath it. It is producing this ‘film’ rapidly, and has gone from my arms to my face to my neck to my chest to my stomach, and I discovered last week that my scalp is covered with some kind of milky covered gooey substance that I can peel off. Not only that, but I can see thick black hairs growing amongst my aged silver/white hair! I was horrified when I observed them on close up pictures I had taken. I have NEVER had black hair, and this hair doesn’t even look like mine. These hairs are three times thicker than my normal hair.

    The Dermatologist specialist (and four other doctors) I was referred to in Denver was not only ignorant as to what may be happening to me, but she made up ridiculous reasons for all the symptoms I showed her, including the blue filaments emerging from my body. She said that my skin is definitely not ‘craping’, it looks like that because of rubbing! Totally false! She said that the blue filaments are totally normal and not coming from skin, but are all over our environment and that’s why I see them on my skin! Really? REALLY!? It is obviously some foreign pathogen invading my body, and I have been shedding it all over my surroundings and anyone I come in contact with. My home and my dog are also infested. I am sick and tired of being told by the medical community that “these things are normal and I would probably benefit from some counseling “! This is NOT normal and I am no doubt shedding this crap everywhere I go.

    It is now causing me great distress and I’m sure I would probably benefit from counseling. But NOT because I am delusional. It’s because I am tired of suffering from sleep deprivation, intense pain in my joints, sores on my body, depression, fear, invisible fibers floating all over my home and my body, and doctors who don’t believe me! This fungus /yeast is trying to kill me and it will if I don’t get some help. I am powerless to fight this thing, and believe me I have tried! Please do what you can to connect me with someone who deals with this. I have reached out to every email address I have come across pertaining to this rapidly spreading condition, and I’ve received no response from anyone. I am praying for a response from you. I don’t know how much longer I can take this.

    Thank you for your time.

    Cindi Haddow
    970-382-1214. May leave msg.

  • Dear Ms. Braswell,

    I am SO glad to have found your article about C. auris! I have been struggling for a years with something affecting my skin, my joints, my dog, my home and my psychi. Without boring you with the intricate details, I will give you a brief summary.

    I began finding what I thought was lint on all of my clothing, in vast amounts. I noticed my skin was darker than normal in March. I started feeling stings on my ankles and lower legs. I found little black specs on my sheets in the morning and on the seat of every chair when I would get up. My whole body itched terribly. I now have blue fibers emerging from my skin in huge numbers that can only be seen with UV light. I have the beginnings of some of my joints being very affected–extremely painful. Seems like there are constantly new symptoms emerging. Needless to say, I was, and am still terrified. About 4 months into this (I was in denial), I put these symptoms in Google and it kept coming up with Morgellons Disease. I have read and read and read, watched video after video and joined support groups, because that is obviously what I have. I met a friend on line who is my main support.

    While watching one of his recent videos, I noticed that he referred quite often to “Candida Auris” and “Aspergillus Fumigatus” – – the fungus. After researching this, I am convinced this is what I have, and I am HEAVILY colonized, as is my home. This IS what I have and perhaps I can shed some light on a couple of things that you article was mentioned. Namely–how it is transmitted, and how to kill it on the environment. It is spread by sheading the invisible fibers from colonized skin, I believe. It is on every square inch of everything in my home including everything in drawers! It is on my dog. Now, I don’t know if that is the only way of transmission, but I observe and wipe them off daily. To make matters worse, the fungus is apparently capable of switching back and forth from a typical yeast and a FC/filamentous phenotype, and is triggered by passage through a mammalian body. The fibers are not only invisible in normal light, but they are lighter than a feather, and can float around the room! I know, I’ve watched it. They will stay wherever they land. With regards to “How to clean it from the environment” – – so far from all I have read, the fungus is resistant to all 3 antifungals and nothing can eradicate it. The only thing possibly effective is Clorox, or whatever the CDC recommends for the cleaning for C-Diff (which I had from 2016-2017 and is also basically Clorox). I, too, am desperately looking for something to get this crap off of everything! I cannot get it to come completely off the inside of my dog’s harness or any number of items of clothing, no matter how or what I use.

    For the record, I had knee replacement surgery in October of 2018. I was in the hospital for 3 days, and then transferred to a nursing home /rehab facility, which I left against doctor’s orders after 24 hours. The place was very old and rundown, the care was horrific and some old woman had been in my bed that morning, violently ill and in the bathroom for 3 hours. They removed her (according to the other patient in my room) after 3 hours. And, oh, I slept in the bed she had been in!

    So, with all the months of being scared to death and afraid to tell anyone (especially after 5 doctors told me I needed to see a psychologist), I am absolutely certain that I have C. auris and my guess would be that either the hospital or the nursing home is where I contracted this horrific, extremely contagious disease. I’ll never know for sure. I am going to find out where I can be tested for both the spirochette bacteria Borellis, as well as C.auris. I am heavily colonized on my skin and systemically inflected. I am tired of suffering all alone with few people believing me! I have emailed a couple of research facilities to volunteer to be studied, with no response. I am a perfect candidate for doing research on, and I wish someone would wake up and realize that I could possibly contribute to the science and medical communities in their efforts to learn more about this condition and how to manage it.

    Thank you for your time.

    Sincerely,

    Cindi C. Haddow
    Ph # 970-382-1214. Lv msg, I don’t answer ph #’s I do not recognize..

  • My first job out of high school prior to college was as a cleaning person at the hospital. Training was 15 hours over 3 days. Then 1 week teamed with an experienced cleaner. Our work was audited multiple random times a week. The hospital was the top in Canada for many years. The workers were well paid and we worked very diligently. Many days I fell asleep on the bus home! This was in 1968. Today cleaning staff are contracted out, poorly paid and barely trained. The problem is with the system and false economies. A life is surely worth more.

  • Why bugs get spread so easily in hospitals is through an area that is too often overlooked, and not taking that department (underpaid, understaffed, under-educated, un-trained, un-supervised) is simplistic, stupid, cheap and outright dangerous. When I was hospitalized for pulmonary embolisms, a nurse tried to give the lady in the bed next to me an enema (constipation after her surgery). The patient screamed in pain, the nurse persisted, the patient climbed out of her bed, and went on all-fours to the bathroom in our shared hospital room, dragging you-know-what behind her. It was 2 am. The patient moaned in the bathroom, the nurse left. Pushing the help button brought no-one, so gasping for air I wobbled to the nursing station, asked them for help with the patient, and cleanup. NO-ONE came, and NOTHING got cleaned up. An hour later some newspaper was thrown on the poop-path. At about 10 am (after breakfast, bathroom visits etc !!!) a “cleaning lady” showed up. She dipped and squeezed the floor mop in the bucket in the hallway only ONCE, and “cleaned” the floors: first the bathroom and on her way back to the hallway the shared hospital room. In other words : she dragged excrement all through the room !! She then took a cloth, dipped it ONCE in another bucket in the hallway, and “cleaned” the surfaces : first the toilet rim and seat (!), then the sink, then its counter, then the windowsill, then some shelves. When she approached my night-table and bed with the same cloth I sent her off in no uncertain terms. THIS IS HOW BUGS SPREAD !!!!!! It was utterly disgusting and 100% un-fit for a hospital, I was aghast. I called my friend (a doctor) and was discharged with his assistance. While I was wheeled out of the ward (my friend and I masked), I saw that ALL the rooms except mine (luckily at the far end of the hallway) had a sign on them : quarantine. Leaving the superbug-infested hospital ward saved my life. Many others (it was Methacillin Resistant Staphylococcus Aureus !!) were not that lucky.
    I did not know this until a few weeks later when I had a meeting with the Hospital Administrator, explaining the “cleaning procedure”. Even with an MRSA infection brewing, cleaning methods had not been stepped up, and cleaning personnel had not been re-instructed / was not supervised etc. Some people in charge of disinfection (including the head of that division) got fired, but for some of the patients on that ward, it was too late – they died.
    There is by far not enough attention and sufficient pay to ensure hospital-appropriate cleaning and disinfecting procedures – and adherence to them. No wonder MRSA, and now (isn’t it a bit very late to finally investigate this?) Candida Auris. What’s next, if this area gets far too little attention ???

  • My husband has some little bites that are brick red and some bigger bites that have alittle pusspockee, also on his over body it looks like he has grayest color on his skin like the stuff you put on burns but we haven’t put anything on him yet & he has more on his chest, neck and shoulders small amount on back his arms and his right wrist very painful and it is swollen and in a lot of pain when having to use it looks to me that its a pretty good bit of bites on that right arm and mostly wrist. My head & neck inches of and we have been working on a houes that was buitl in 1927 the have to take out & and he took out all the old insulation old plumbing termite reinfesemest lumber this old house fixing it up butt taken out any old furnishings all old stuff and putting new in. He is in a lot of pain. Now he is havi duel & aches its is very painful. Please let us

  • What about using tea tree oil on surfaces to fight this fungus or grapefruit extract..both work well to inhibit yeast. Perhaps the patients could be given grapefruit extract also. Best Wishes!

  • I believe that a majority of your most serious, avid readers, researchers, and patients and their families would appreciate your inclusion of topic/source citations/links.

  • Excellent article. There needs to be a technology that conforms to existing protocols but does a better job. Changing the way people are currently performing a certain task is very difficult.

  • For a current, in-depth look at this topic see Matt McCarthy’s “Superbugs”.
    Dr. McCarthy provides the reader with a historical perspective and numerous future insights on this important topic.

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