Health officials are warning of “a serious global health threat” from a drug-resistant superbug fungus. The Centers for Disease Control and Prevention says the fungus, Candida auris, has already sickened hundreds of people in the United States.
Candida auris, which preys on people with weakened immune systems, was first identified in 2009 and first seen in this country in 2013. Since then, it has caused at least 587 illnesses in the U.S. More than 300 of those cases were reported in New York state. Illinois had 144 confirmed cases, primarily in the Chicago area, and New Jersey had 104.
“This is definitely an alarming development in the global emerging threat of superbugs,” Dr. Neeta Ogden, an internal medicine specialist, told CBS News.
“It’s resistant to multiple anti-fungal drugs that we have, and it’s also resistant to all the things that we use to eradicate bacteria and fungal strains in the hospital.”
CBS New York reports an elderly man died from the fungus last year at Mount Sinai Hospital following abdominal surgery. The fungus has caused illnesses globally with reports in more than 20 countries.
What kind of infections does Candida auris cause?
Candida auris can cause different types of infections, including bloodstream infection, wound infection, and ear infection.
The fungus has also been detected in respiratory and urine samples, but the CDC says it’s unclear if it causes lung or bladder infections.
Who is at risk of illness from Candida auris?
Candida auris infections have been reported in health care settings throughout the world, including hospitals and long-term care facilities like nursing homes. People who recently had surgery, live in nursing homes, or who have breathing tubes, feeding tubes or central venous catheters appear to be at highest risk.
“This strain is preying on people with weakened immune systems,” Ogden said. “So who is that? Long-term health care facility residents who have catheters, in-dwelling catheters or IV lines. People in hospitals, IUCs. Newborns. And also people who take immunosuppressant drugs for medical illnesses, or have diabetes. So those are the people who really are at risk.”
The germ has been found in patients of all ages, from preterm infants to older adults.
How is Candida auris spread?
Candida strains “live in our gut microbiome,” Ogden explained. The drug-resistant strain Candida auris has taken hold in some health care settings, spreading person to person or through contact with contaminated surfaces or equipment. Healthy people with strong immune systems may carry the germ without actually getting sick from it.
Ogden said health officials are worried about what could come next.
“The greater concern is that if we don’t curb this rise of superbugs, where is this headed? It’s headed towards normal, healthy people with no health problems becoming vulnerable to these types of fungal strains, and not having anything in our defenses of antimicrobials and antifungals to fight them,” she said.
How are Candida auris infections diagnosed?
According to the CDC, symptoms of Candida auris may be difficult to detect because patients are often already sick. Only a lab test can identify the superbug.
Infections are usually diagnosed by culture of blood or other body fluids.
Are Candida auris infections treatable?
While most Candida auris infections are treatable with antifungal medications, health officials say they’re concerned that some have proven to be resistant to all three main classes of antifungal medications.
“In this situation, multiple antifungal medications at high doses may be needed to treat the infection,” the CDC said.
“It’s an enormous problem,” Matthew Fisher, a professor of fungal epidemiology at Imperial College London, told The New York Times. “We depend on being able to treat those patients with antifungals.” Fisher co-authored a recent scientific review documenting the rise of drug-resistant fungi.
How often do the infections turn deadly?
Since Candida auris infections generally occur in people who are already sick with serious medical conditions, it can be difficult to determine cause of death.
“Based on information from a limited number of patients, 30–60% of people with C. auris infections have died,” the CDC says. “However, many of these people had other serious illnesses that also increased their risk of death.”
Toxins from household fungi can easily become airborne.
They can cause health problems, related to “sick building syndrome.”
Researchers said the area is understudied.
Toxins from household fungi can easily become airborne and cause health problems, a new study has found.
A group of researchers found that three types of fungus that can grow on ordinary household wallpaper can spread into the air. They said the effects of the airborne transmission on human health are understudied.
Fungal toxins, also called mycotoxins, should be taken seriously as a source of indoor air pollution, and so-called sick building syndrome, the researchers said.
“We demonstrated that mycotoxins could be transferred from a moldy material to air, under conditions that may be encountered in buildings,” said study co-author Jean-Denis Bailly, a professor of food hygiene at the National Veterinary School of Toulouse in France, in a release. “Thus, mycotoxins can be inhaled and should be investigated as parameters of indoor air quality, especially in homes with visible fungal contamination.”
They published the results Friday in the American Society for Microbiology’s journal Applied and Environmental Microbiology.
The researchers said far less research exists on the dangers of airborne fungal toxins than on fungal toxins in foods.
Thus, they focused on three fungi commonly found in contaminated food: Penicillium brevicompactum, Aspergillus versicolor and Stachybotrys chartarum.
The team created a flowing stream of air over a piece of wallpaper contaminated with the three fungi and analyzed samples of the air.
They found that some toxins were present on tiny particles of dust, that people or animals could easily inhale. They also found the different species sent different amounts of fungal toxins into the air, which might allow future researchers to prioritize efforts.
Very little research has been done on the effect of such toxins once they have been inhaled, the researchers said in the release.
Scientists have highlighted the dangers of indoor air pollution before. While much attention is focused on airborne pollutants from car emissions, factories and power plants, others such as household mold, chemical fumes and smoke can pose dangers within the home.
Bailly said energy efficiency efforts may even be exacerbating the problem, as houses are increasingly insulated to save on heating and cooling. These kinds of environments may worsen the development of fungus in moist areas, such as in bathrooms, or appliances that use water, like coffee makers.
“The presence of mycotoxins in indoors should be taken into consideration as an important parameter of air quality,” Bailly said.
Residents living in newly built homes in Parkland are complaining of mold, and at least two big builders have taken steps to fix the problem.
Sowande Johnson, director of development services for Parkland, said WCI Communities Inc. and Standard Pacific of Florida have been approved for permits to complete work that they hope will eliminate the fungus.
A third builder, Toll Brothers, has said it also plans to apply for a permit, Johnson said.
Those companies, along with Lennar Homes, are building hundreds of high-end homes in Parkland, the last available area for large-scale residential construction in Broward County. Johnson said he hasn’t heard of any problems with the Lennar properties.
Johnson said the city has received a few complaints, and he doesn’t have “even the slightest idea” how many homes may be affected.
WCI’s permit application outlines plans to install a dehumidifier, while Standard Pacific is using spray foam insulation. Johnson said it may take a few months to determine whether the proposed fixes will work.
“We’ll have to wait until things heat up [in the summer] to find out if it’s a true solution,” Johnson said. “If not, they’ll have to come back with another solution to remedy the problem.”
Jon Rapaport, division president for WCI, said the Bonita Springs-based builder received a “couple of dozen complaints” but not all of those homeowners had mold.
Still, out of an abundance of caution, WCI made modifications in more than 100 Heron Bay homes at no charge to the owners, he said.
Rapaport attributed the mold to a design issue. WCI sealed openings and made changes to ventilation that lets moisture leave attics. In addition, WCI is offering the dehumidifiers to homeowners, he said.
“We wanted to do the right thing,” Rapaport said. “Now we seem to not have a problem at all.”
WCI, expected to soon merge with Lennar as part of a $643 million deal, has built the vast majority of the nearly 3,000 homes in Heron Bay over the past two decades. The master-planned development, off the Sawgrass Expressway at Coral Ridge Drive, is one of the largest in the region.
Standard Pacific, which builds in the Watercrest at Parkland community, did not respond to requests for comment. In 2015, the company combined with Ryland Homes to form CalAtlantic Group of Irvine, Calif.
Horsham, Pa.-based Toll Brothers builds in the Parkland Golf & Country Club. A publicist for Toll said officials were not available to comment, but she released a statement from the company.
“Toll Brothers stands behind its homes with a comprehensive warranty and we work with our homeowners and provide them with information on operating their home systems efficiently and within their design criteria,” the statement said.
In 2015, Angela Mesa-Taylor moved into a rented home in Heron Bay’s Osprey Lake subdivison. Soon after, she noticed that she and her children were constantly sick, but she just thought it was her young twins bringing home coughs and colds from their play dates.
Then her housekeeper pointed to mold on the ceiling in the master bathroom. Another bathroom had the same problem, she said.
Mesa-Taylor said the builder, WCI, tried to address her concerns, but the mold persisted. Meanwhile, she said she heard similar complaints from neighbors.
Within days of discovering the mold, Mesa-Taylor said she moved her children out of the home and continued to press WCI for answers. Not satisfied with the results, she filed suit last summer in Broward County Circuit Court. The complaint was amended in November.
“Every fix was not a fix,” said Mesa-Taylor, 38. “It seemed to be very, very temporary and superficial.”
The suit, which seeks damages in excess of $15,000, alleges that the mold was caused by design and construction defects and led to chronic health problems.
An attorney for the builder declined to discuss the case. Rapaport, the WCI division president, said he can’t comment on pending litigation.
Scott Gelfand, Mesa-Taylor’s Coral Springs lawyer, said he has spoken to more than 100 owners complaining of mold in Heron Bay homes built within the last several years. Some may be reluctant to discuss the problem publicly because they’re worried about property values, but homes that are properly remediated tend to sell for full market value, he said.
Johnson, the development services director for Parkland, said he suspects mold is occurring in other homes across Florida. But Truly Burton, executive vice president of the Builders Association of South Florida, said she isn’t aware of an ongoing problem statewide.
David Cobb, a former homebuilder and now a regional director for the Metrostudy research firm, agrees that mold is common in a humid climate and often is the result of workmanship issues.
But Cobb also cited another cause: improper home maintenance. He said homeowners should inspect homes annually, caulking around windows and doors and painting every few years to keep mold at bay.
“People who buy new homes say, ‘It’s new, so I don’t have to do anything to it,’ and that is totally incorrect,” Cobb said.
PALO ALTO (KPIX) — A deadly water mold called Phytophthora (literally, “plant-destroyer”) is threatening to wipe out native California plants.
Local plants have no immunity to the fungus-like organism, which may have hitch-hiked into the state from other countries on infected plants or pots.
Non-profit Grassroots Ecology is battling Phytophthora at their nursery, which provides plants to the Mid-Peninsula Open Space District and the Valley Water District for wildland-restoration projects. Their first line of defense: no one gets to enter the nursery until they’ve cleaned their shoes.
“Alcohol kills the pathogens,” Deanna Giuliano, with Grassroots Ecology, said.
In addition to shoe-cleaning, the nursery in the Palo Alto hills, has taken all plants off the ground to avoid splash contamination and pasteurizes the soil. Hoses and tools are kept off the ground, as well.
“I feel like all these new protocols are helping. I’ve seen a difference in the plants, they look healthier,” Giuliano remarked.
Those protocols are driving up prices. The cost of native plants coming from nurseries like Giuliano’s has doubled.
“Each of the plants in this shade house will eventually be replanted in the wild by the Open Space Preserve but not one of the plants will leave here without first being tested,” Giuliano said.
These efforts aren’t cheap or easy but they’re essential in conquering Phytophthora, according to Cindy Roessler, with the Mid-Peninsula Opens Space District.
“If we go out and put in new native plants in a preserve and they’re diseased, those plants will die but there is also a chance that their roots will spread the disease from those plants into the natural areas around them,” Roessler said.
Early diagnosis, effective therapy vital for treatment of deadly invasive mold
New guidelines focus on new treatments, early diagnosis of fungal infection
The updated guidelines focus on the diagnosis and treatment of the major forms of aspergillosis: allergic, chronic and invasive, the latter which kills 40 percent to 80 percent of those with widespread infection. An airborne invasive mold, aspergillus often is found in air conditioning units, compost piles and damp or flood-damaged homes or buildings. While generally harmless, it can cause an allergic reaction or chronic lung problems in some people and serious, invasive disease in vulnerable patients. Those at highest risk are people whose immune systems are suppressed, such as those undergoing stem cell and lung and other organ transplants. The infection also can affect those with severe influenza or who are on long-term steroids, or patients in the intensive care unit. “Invasive mold (aspergillosis) often is overlooked, but early diagnosis and treatment are key,” said Thomas Patterson, MD, lead author of the guidelines and chief of the Division of Infectious Disease and professor of medicine at The University of Texas Health Science Center at San Antonio and South Texas Veterans Health Care System, San Antonio. “These are complicated infections with a number of treatment options. Patients really benefit from a multidisciplinary approach, including the expertise of an infectious disease specialist.” Updating the 2008 guidelines, the new guidelines for the diagnosis and treatment of aspergillosis highlight the increased evidence for antifungal therapy recommendations as well as diagnostic tests. The improved use of diagnostic tools has enhanced the ability to identify the infection early, the guidelines note. These include blood tests, cultures and computed tomography (CT) imaging. Because some of the methods are invasive — such as taking a culture directly from the lungs — physicians often are reluctant to proceed. Because the infection is so deadly, physicians should be aggressive in diagnosing patients suspected of having the infection, Dr. Patterson notes. Additionally, new more-effective and better-tolerated antifungal medications, or versions of existing medications (e.g. extended release) have improved care, including isavuconazole and posaconazole. In some cases, combination therapy with voriconazole and an echinocandin is recommended for certain patients at highest risk. Because invasive molds like aspergillis are s so deadly, the guidelines recommend some patients at highest risk be treated with antifungals to prevent infection, including those with neutropenia and graft versus host disease (GVHD). Another prevention strategy is the use of special filtration systems for hospitalized immunosuppressed patients. Invasive aspergillosis affects about 200,000 people worldwide, Dr. Patterson said. The allergic form is most common and affects more than 4 million people worldwide, according to the Centers for Disease Control and Prevention (CDC). Those with asthma and cystic fibrosis are at highest risk of developing allergic aspergillosis. The other major form is chronic pulmonary aspergillosis, which can affect healthy people, and occurs in about 400,000 people worldwide, the CDC notes. While requiring treatment, the allergic and chronic forms of aspergillosis typically aren’t deadly. AT A GLANCE
A deadly fungal infection, invasive aspergillosis should be diagnosed early to improve care, according to new guidelines from IDSA. New and improved therapies are expanding treatment options.
Immunocompromised patients are at highest risk for invasive aspergillosis. The mortality rate in those patients is 40 percent or higher.
Aspergillus is a mold that is in the air we breathe, particularly in air conditioning units and flood-damaged areas.
In addition to the invasive form, aspergillus can cause chronic and allergic forms of disease.