Jan Dyer

Hospital-acquired conditions (HACs) are still trending downward, with 3 million fewer adverse events (AEs)—a 21% drop—over a 5-year period, according to the recently released National Scorecard on Rates of Hospital-Acquired Conditions. Thanks in part to provisions of the Affordable Care Act, HHS says, about 125,000 fewer patients died due to HACs, and > $28 billion in health care costs was saved.

Agency for Healthcare Research and Quality (AHRQ) researchers used national data systems to analyze the incidence of 28 HACs that occurred from 2010 to 2015. The list included AEs, catheter-associated urinary tract infections, central-line associated bloodstream infections, pressure ulcers, and surgical site infections, selected as focus areas because they’re common and considered preventable.

AHRQ’s Comprehensive Unit-based Safety Program (CUSP) is one of the tools used most often to reduce HACs. It’s a proven method, HHS says, that combines improvement in safety culture, teamwork, and communications with evidence-based practices to protect patients. AHRQ has “worked hand-in-hand with frontline clinicians” to help them use CUSP in a series of “highly effective” nationwide projects.

“AHRQ has been building a foundation of patient safety research for the last decade and a half at the request of Congress,” said AHRQ director Andy Bindman, MD. “Now we’re seeing these investments continue to pay off in terms of lives saved, harm avoided, and safer care delivery overall.”

Hospital-acquired conditions (HACs) are still trending downward, with 3 million fewer adverse events (AEs)—a 21% drop—over a 5-year period, according to the recently released National Scorecard on Rates of Hospital-Acquired Conditions. Thanks in part to provisions of the Affordable Care Act, HHS says, about 125,000 fewer patients died due to HACs, and > $28 billion in health care costs was saved.

Agency for Healthcare Research and Quality (AHRQ) researchers used national data systems to analyze the incidence of 28 HACs that occurred from 2010 to 2015. The list included AEs, catheter-associated urinary tract infections, central-line associated bloodstream infections, pressure ulcers, and surgical site infections, selected as focus areas because they’re common and considered preventable.

AHRQ’s Comprehensive Unit-based Safety Program (CUSP) is one of the tools used most often to reduce HACs. It’s a proven method, HHS says, that combines improvement in safety culture, teamwork, and communications with evidence-based practices to protect patients. AHRQ has “worked hand-in-hand with frontline clinicians” to help them use CUSP in a series of “highly effective” nationwide projects.

“AHRQ has been building a foundation of patient safety research for the last decade and a half at the request of Congress,” said AHRQ director Andy Bindman, MD. “Now we’re seeing these investments continue to pay off in terms of lives saved, harm avoided, and safer care delivery overall.”

Hospital-acquired conditions (HACs) are still trending downward, with 3 million fewer adverse events (AEs)—a 21% drop—over a 5-year period, according to the recently released National Scorecard on Rates of Hospital-Acquired Conditions. Thanks in part to provisions of the Affordable Care Act, HHS says, about 125,000 fewer patients died due to HACs, and > $28 billion in health care costs was saved.

Agency for Healthcare Research and Quality (AHRQ) researchers used national data systems to analyze the incidence of 28 HACs that occurred from 2010 to 2015. The list included AEs, catheter-associated urinary tract infections, central-line associated bloodstream infections, pressure ulcers, and surgical site infections, selected as focus areas because they’re common and considered preventable.

AHRQ’s Comprehensive Unit-based Safety Program (CUSP) is one of the tools used most often to reduce HACs. It’s a proven method, HHS says, that combines improvement in safety culture, teamwork, and communications with evidence-based practices to protect patients. AHRQ has “worked hand-in-hand with frontline clinicians” to help them use CUSP in a series of “highly effective” nationwide projects.

“AHRQ has been building a foundation of patient safety research for the last decade and a half at the request of Congress,” said AHRQ director Andy Bindman, MD. “Now we’re seeing these investments continue to pay off in terms of lives saved, harm avoided, and safer care delivery overall.”

As many as 2.7 million American workers might have asthma that their work may have caused or worsened, say CDC researchers. Data from the 2006-2007 Behavioral Risk Factor Surveillance System Asthma Call-back Survey in 33 states revealed that nearly half of adult asthma could be related to work, and thus potentially preventable.

Of the respondents employed in the previous year, 7.7% had asthma, ranging from 5% in Mississippi to 10% in Michigan. Among the 21 states that collected information on industry and occupation, prevalence of asthma was highest among workers in health care support occupations in Michigan (21.5%). In fact, health care ranked first among the 5 industries with the highest asthma prevalence, and health care practitioners ranked second among the 5 occupational groups with the highest asthma prevalence.

Different industries and occupations have different irritants. In health care, for instance, cleaning and disinfection products, powdered latex gloves, and aerosolized medications have doubled the likelihood of new-onset asthma, the report notes. But it’s possible to make a big dent in the illness prevalence with evidence-based changes. The researchers say powder-free natural rubber latex or nonlatex gloves, for instance, “considerably reduced” workplace asthma in the health care industry,

The researchers say their findings might help physicians and state public health officials identify workers who should be evaluated for work-related asthma, in order to plan and target interventions.

As many as 2.7 million American workers might have asthma that their work may have caused or worsened, say CDC researchers. Data from the 2006-2007 Behavioral Risk Factor Surveillance System Asthma Call-back Survey in 33 states revealed that nearly half of adult asthma could be related to work, and thus potentially preventable.

Of the respondents employed in the previous year, 7.7% had asthma, ranging from 5% in Mississippi to 10% in Michigan. Among the 21 states that collected information on industry and occupation, prevalence of asthma was highest among workers in health care support occupations in Michigan (21.5%). In fact, health care ranked first among the 5 industries with the highest asthma prevalence, and health care practitioners ranked second among the 5 occupational groups with the highest asthma prevalence.

Different industries and occupations have different irritants. In health care, for instance, cleaning and disinfection products, powdered latex gloves, and aerosolized medications have doubled the likelihood of new-onset asthma, the report notes. But it’s possible to make a big dent in the illness prevalence with evidence-based changes. The researchers say powder-free natural rubber latex or nonlatex gloves, for instance, “considerably reduced” workplace asthma in the health care industry,

The researchers say their findings might help physicians and state public health officials identify workers who should be evaluated for work-related asthma, in order to plan and target interventions.

As many as 2.7 million American workers might have asthma that their work may have caused or worsened, say CDC researchers. Data from the 2006-2007 Behavioral Risk Factor Surveillance System Asthma Call-back Survey in 33 states revealed that nearly half of adult asthma could be related to work, and thus potentially preventable.

Of the respondents employed in the previous year, 7.7% had asthma, ranging from 5% in Mississippi to 10% in Michigan. Among the 21 states that collected information on industry and occupation, prevalence of asthma was highest among workers in health care support occupations in Michigan (21.5%). In fact, health care ranked first among the 5 industries with the highest asthma prevalence, and health care practitioners ranked second among the 5 occupational groups with the highest asthma prevalence.

Different industries and occupations have different irritants. In health care, for instance, cleaning and disinfection products, powdered latex gloves, and aerosolized medications have doubled the likelihood of new-onset asthma, the report notes. But it’s possible to make a big dent in the illness prevalence with evidence-based changes. The researchers say powder-free natural rubber latex or nonlatex gloves, for instance, “considerably reduced” workplace asthma in the health care industry,

The researchers say their findings might help physicians and state public health officials identify workers who should be evaluated for work-related asthma, in order to plan and target interventions.

Even as the prevalence of childhood overweight and obesity in the U.S. has climbed to an all-time high, say University of Oklahoma researchers, American Indian children have disproportionately high rates. But intervention studies usually don’t include them because they’re in small populations in rural areas.

The researchers developed a program, Middle School Opportunity for Vigorous Exercise (MOVE) for the Anadarko Middle School, which has an average fall enrollment of 442 students aged 12 to 15 years. They based the program on an exercise prescription suggested by the 1996 report by the surgeon general, Physical Activity and Health. They aimed at getting the students to walk or run 1 mile each school day and then engage in a team activity such as basketball, soccer, football, dodge ball, or volleyball. The intervention involved about 20 students per class and took place during 5 school years.

The researchers measured changes in body mass index (BMI) among participants and nonparticipants. During the study period, 46 boys and 20 girls met the criterion of participating for 2 consecutive semesters. Of those, > 50% were American Indian. At baseline, 10 were overweight and 19 were obese.

The MOVE participants had a significantly smaller increase in BMI than that of  nonparticipants. Mean BMI scores remained the same among girls participating in MOVE but increased for nonparticipating girls. Mean BMI score decreased among boys participating in MOVE and increased among nonparticipating boys.

Although the changes were small—and the girls’ BMIs remained stable—their program demonstrates that improvements can be achieved, the researchers say. A curriculum that encourages a healthy lifestyle in general is important, but specifically, they suggest, daily walking or running may be needed to maintain or reduce BMI. Moreover, it could help establish a crucial habit of regular physical activity in the young.

Even as the prevalence of childhood overweight and obesity in the U.S. has climbed to an all-time high, say University of Oklahoma researchers, American Indian children have disproportionately high rates. But intervention studies usually don’t include them because they’re in small populations in rural areas.

The researchers developed a program, Middle School Opportunity for Vigorous Exercise (MOVE) for the Anadarko Middle School, which has an average fall enrollment of 442 students aged 12 to 15 years. They based the program on an exercise prescription suggested by the 1996 report by the surgeon general, Physical Activity and Health. They aimed at getting the students to walk or run 1 mile each school day and then engage in a team activity such as basketball, soccer, football, dodge ball, or volleyball. The intervention involved about 20 students per class and took place during 5 school years.

The researchers measured changes in body mass index (BMI) among participants and nonparticipants. During the study period, 46 boys and 20 girls met the criterion of participating for 2 consecutive semesters. Of those, > 50% were American Indian. At baseline, 10 were overweight and 19 were obese.

The MOVE participants had a significantly smaller increase in BMI than that of  nonparticipants. Mean BMI scores remained the same among girls participating in MOVE but increased for nonparticipating girls. Mean BMI score decreased among boys participating in MOVE and increased among nonparticipating boys.

Although the changes were small—and the girls’ BMIs remained stable—their program demonstrates that improvements can be achieved, the researchers say. A curriculum that encourages a healthy lifestyle in general is important, but specifically, they suggest, daily walking or running may be needed to maintain or reduce BMI. Moreover, it could help establish a crucial habit of regular physical activity in the young.

Even as the prevalence of childhood overweight and obesity in the U.S. has climbed to an all-time high, say University of Oklahoma researchers, American Indian children have disproportionately high rates. But intervention studies usually don’t include them because they’re in small populations in rural areas.

The researchers developed a program, Middle School Opportunity for Vigorous Exercise (MOVE) for the Anadarko Middle School, which has an average fall enrollment of 442 students aged 12 to 15 years. They based the program on an exercise prescription suggested by the 1996 report by the surgeon general, Physical Activity and Health. They aimed at getting the students to walk or run 1 mile each school day and then engage in a team activity such as basketball, soccer, football, dodge ball, or volleyball. The intervention involved about 20 students per class and took place during 5 school years.

The researchers measured changes in body mass index (BMI) among participants and nonparticipants. During the study period, 46 boys and 20 girls met the criterion of participating for 2 consecutive semesters. Of those, > 50% were American Indian. At baseline, 10 were overweight and 19 were obese.

The MOVE participants had a significantly smaller increase in BMI than that of  nonparticipants. Mean BMI scores remained the same among girls participating in MOVE but increased for nonparticipating girls. Mean BMI score decreased among boys participating in MOVE and increased among nonparticipating boys.

Although the changes were small—and the girls’ BMIs remained stable—their program demonstrates that improvements can be achieved, the researchers say. A curriculum that encourages a healthy lifestyle in general is important, but specifically, they suggest, daily walking or running may be needed to maintain or reduce BMI. Moreover, it could help establish a crucial habit of regular physical activity in the young.

Fever is thought of as the most common presenting symptom of flu in hospital emergency departments, although it’s known that adults may have atypical presentations. But according to a study by researchers from University of New South Wales in Australia, The Beijing Centre for Disease Prevention and Control in China, The National Institute of Hygiene and Epidemiology in Vietnam, and Arizona State University, > 75% of adults with a viral respiratory infection (including influenza) do not have fever.  

Related: Predicting Flu Epidemics

The researchers analyzed data from 158 health care workers who had laboratory-confirmed viral infections. The viruses included rhinovirus, respiratory syncytial virus, parainfluenza virus, influenza virus, human metapneumovirus, coronavirus, and adenovirus.  In 15 cases, > 1 virus was isolated, including 9 cases with influenza co-infection.

Twenty-five percent of 75 patients with rhinovirus had fever. Of 10 patients with influenza A, 3 had fever. Co-infection with > 1 virus was the strongest predictor of fever. When cases of influenza and a co-infection were included, 8 of 22 patients had fever (36%).

Related: Predicting Whose Flu Will Be Worse

The accepted definition of “influenza-like illness” includes fever as a symptom, the researchers note. But when it comes to treating and reducing the risk of transmission, it helps to be aware that a diagnosis of viral respiratory infection is possible in the absence of fever. That awareness could be especially important for infections that are transmissible when patients are asymptomatic or presymptomatic. The main clinical implication, the researchers say, is that the case definition for influenza-like illness in adults may be “highly insensitive.”

Fever is thought of as the most common presenting symptom of flu in hospital emergency departments, although it’s known that adults may have atypical presentations. But according to a study by researchers from University of New South Wales in Australia, The Beijing Centre for Disease Prevention and Control in China, The National Institute of Hygiene and Epidemiology in Vietnam, and Arizona State University, > 75% of adults with a viral respiratory infection (including influenza) do not have fever.  

Related: Predicting Flu Epidemics

The researchers analyzed data from 158 health care workers who had laboratory-confirmed viral infections. The viruses included rhinovirus, respiratory syncytial virus, parainfluenza virus, influenza virus, human metapneumovirus, coronavirus, and adenovirus.  In 15 cases, > 1 virus was isolated, including 9 cases with influenza co-infection.

Twenty-five percent of 75 patients with rhinovirus had fever. Of 10 patients with influenza A, 3 had fever. Co-infection with > 1 virus was the strongest predictor of fever. When cases of influenza and a co-infection were included, 8 of 22 patients had fever (36%).

Related: Predicting Whose Flu Will Be Worse

The accepted definition of “influenza-like illness” includes fever as a symptom, the researchers note. But when it comes to treating and reducing the risk of transmission, it helps to be aware that a diagnosis of viral respiratory infection is possible in the absence of fever. That awareness could be especially important for infections that are transmissible when patients are asymptomatic or presymptomatic. The main clinical implication, the researchers say, is that the case definition for influenza-like illness in adults may be “highly insensitive.”

Fever is thought of as the most common presenting symptom of flu in hospital emergency departments, although it’s known that adults may have atypical presentations. But according to a study by researchers from University of New South Wales in Australia, The Beijing Centre for Disease Prevention and Control in China, The National Institute of Hygiene and Epidemiology in Vietnam, and Arizona State University, > 75% of adults with a viral respiratory infection (including influenza) do not have fever.  

Related: Predicting Flu Epidemics

The researchers analyzed data from 158 health care workers who had laboratory-confirmed viral infections. The viruses included rhinovirus, respiratory syncytial virus, parainfluenza virus, influenza virus, human metapneumovirus, coronavirus, and adenovirus.  In 15 cases, > 1 virus was isolated, including 9 cases with influenza co-infection.

Twenty-five percent of 75 patients with rhinovirus had fever. Of 10 patients with influenza A, 3 had fever. Co-infection with > 1 virus was the strongest predictor of fever. When cases of influenza and a co-infection were included, 8 of 22 patients had fever (36%).

Related: Predicting Whose Flu Will Be Worse

The accepted definition of “influenza-like illness” includes fever as a symptom, the researchers note. But when it comes to treating and reducing the risk of transmission, it helps to be aware that a diagnosis of viral respiratory infection is possible in the absence of fever. That awareness could be especially important for infections that are transmissible when patients are asymptomatic or presymptomatic. The main clinical implication, the researchers say, is that the case definition for influenza-like illness in adults may be “highly insensitive.”

Although syringe services programs (SSPs) are attracting those who would benefit from this service, many patients still aren’t always using sterile needles, according to a CDC Vital Signs report. Thus, they’re still at risk for HIV and hepatitis B and C infection.

Researchers conducted a study in 22 U.S. cities with a high number of HIV cases of people who inject drugs. In 2015, > 50% of people who inject drugs said they used an SSP in the previous year compared with about one-third in 2005. But the percentage of people who received at least 1 syringe from an SSP and shared syringes was about the same as those who had not received any syringes from SSPs (31% vs 38%).

The good news is that annual AIDS diagnoses among people who inject drugs have dropped by 90%. Nonetheless, about 9% of HIV infections diagnosed each year is due to injecting drugs. Injection drug use has also contributed to a 150% rise in acute cases of hepatitis C infections.

But prevention efforts are paying off in the African American and Latino communities, said Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention. The number of African Americans getting all syringes from SSPs was up by 48%, and the number sharing syringes was down 34% from 2005. The number of HIV diagnoses among African Americans who inject drugs declined by 60% from 2008 to 2014.

Syringe sharing also was down 12% among Latinos, and HIV diagnoses dropped by 50% from 2008 to 2014.

By contrast, whites who inject drugs continue to share at similar levels—45% in 2005, vs 43% in 2015. The number receiving all syringes from sterile sources remained unchanged at 22%, and HIV diagnoses remained stable from 2012 to 2014.

Recent trends indicate that heroin use and injection drug use among whites are rising; that, coupled with high rates of syringe sharing, might “challenge the decades of progress in HIV prevention,” the researchers say. They also point to obstacles such as a potential lack of sufficient sterile equipment, too few SSPs in rural areas, and absence of legal support in many states.

Decisions about SSPs are made at state and local levels, the report notes. In 2015, Congress gave states and local communities the opportunity to use federal funds to support “certain components of comprehensive SSPs,” which also offer or refer people to prevention, care, and treatment.

Related: Changing Treatment Landscape of Hepatitis C Virus Infection Among Penitentiary Inmates

“Until now, the nation has made substantial progress in preventing HIV among people who inject drugs, but this success is threatened,” said Jonathan Mermin, MD, MPH, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “Syringe services programs work, and their expansion is pivotal for progress in the coming decades.”

Although syringe services programs (SSPs) are attracting those who would benefit from this service, many patients still aren’t always using sterile needles, according to a CDC Vital Signs report. Thus, they’re still at risk for HIV and hepatitis B and C infection.

Researchers conducted a study in 22 U.S. cities with a high number of HIV cases of people who inject drugs. In 2015, > 50% of people who inject drugs said they used an SSP in the previous year compared with about one-third in 2005. But the percentage of people who received at least 1 syringe from an SSP and shared syringes was about the same as those who had not received any syringes from SSPs (31% vs 38%).

The good news is that annual AIDS diagnoses among people who inject drugs have dropped by 90%. Nonetheless, about 9% of HIV infections diagnosed each year is due to injecting drugs. Injection drug use has also contributed to a 150% rise in acute cases of hepatitis C infections.

But prevention efforts are paying off in the African American and Latino communities, said Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention. The number of African Americans getting all syringes from SSPs was up by 48%, and the number sharing syringes was down 34% from 2005. The number of HIV diagnoses among African Americans who inject drugs declined by 60% from 2008 to 2014.

Syringe sharing also was down 12% among Latinos, and HIV diagnoses dropped by 50% from 2008 to 2014.

By contrast, whites who inject drugs continue to share at similar levels—45% in 2005, vs 43% in 2015. The number receiving all syringes from sterile sources remained unchanged at 22%, and HIV diagnoses remained stable from 2012 to 2014.

Recent trends indicate that heroin use and injection drug use among whites are rising; that, coupled with high rates of syringe sharing, might “challenge the decades of progress in HIV prevention,” the researchers say. They also point to obstacles such as a potential lack of sufficient sterile equipment, too few SSPs in rural areas, and absence of legal support in many states.

Decisions about SSPs are made at state and local levels, the report notes. In 2015, Congress gave states and local communities the opportunity to use federal funds to support “certain components of comprehensive SSPs,” which also offer or refer people to prevention, care, and treatment.

Related: Changing Treatment Landscape of Hepatitis C Virus Infection Among Penitentiary Inmates

“Until now, the nation has made substantial progress in preventing HIV among people who inject drugs, but this success is threatened,” said Jonathan Mermin, MD, MPH, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “Syringe services programs work, and their expansion is pivotal for progress in the coming decades.”

Although syringe services programs (SSPs) are attracting those who would benefit from this service, many patients still aren’t always using sterile needles, according to a CDC Vital Signs report. Thus, they’re still at risk for HIV and hepatitis B and C infection.

Researchers conducted a study in 22 U.S. cities with a high number of HIV cases of people who inject drugs. In 2015, > 50% of people who inject drugs said they used an SSP in the previous year compared with about one-third in 2005. But the percentage of people who received at least 1 syringe from an SSP and shared syringes was about the same as those who had not received any syringes from SSPs (31% vs 38%).

The good news is that annual AIDS diagnoses among people who inject drugs have dropped by 90%. Nonetheless, about 9% of HIV infections diagnosed each year is due to injecting drugs. Injection drug use has also contributed to a 150% rise in acute cases of hepatitis C infections.

But prevention efforts are paying off in the African American and Latino communities, said Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention. The number of African Americans getting all syringes from SSPs was up by 48%, and the number sharing syringes was down 34% from 2005. The number of HIV diagnoses among African Americans who inject drugs declined by 60% from 2008 to 2014.

Syringe sharing also was down 12% among Latinos, and HIV diagnoses dropped by 50% from 2008 to 2014.

By contrast, whites who inject drugs continue to share at similar levels—45% in 2005, vs 43% in 2015. The number receiving all syringes from sterile sources remained unchanged at 22%, and HIV diagnoses remained stable from 2012 to 2014.

Recent trends indicate that heroin use and injection drug use among whites are rising; that, coupled with high rates of syringe sharing, might “challenge the decades of progress in HIV prevention,” the researchers say. They also point to obstacles such as a potential lack of sufficient sterile equipment, too few SSPs in rural areas, and absence of legal support in many states.

Decisions about SSPs are made at state and local levels, the report notes. In 2015, Congress gave states and local communities the opportunity to use federal funds to support “certain components of comprehensive SSPs,” which also offer or refer people to prevention, care, and treatment.

Related: Changing Treatment Landscape of Hepatitis C Virus Infection Among Penitentiary Inmates

“Until now, the nation has made substantial progress in preventing HIV among people who inject drugs, but this success is threatened,” said Jonathan Mermin, MD, MPH, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “Syringe services programs work, and their expansion is pivotal for progress in the coming decades.”

In 2009, Candida auris, an emerging invasive multidrug-resistant fungus, was isolated from external ear canal discharge of a patient in Japan. Since then, at least a dozen countries, including India, Israel, South Korea, and the United Kingdom, have published reports of C auris infections.

The emergence of C auris raises several serious concerns for public health, according to Morbidity and Mortality Weekly Report: Many isolates are multidrug-resistant; some strains have elevated minimum inhibitory concentrations to drugs in all 3 major classes of antifungal medications—a feature not found in other clinically relevant Candida species. Second, it’s challenging to identify, requiring specialized methods. C auris is often misidentified as other yeasts (most commonly Candida haemulonii). Finally, C auris has caused outbreaks in health care settings.

In June 2016, the CDC issued a clinical alert asking clinicians, public health authorities, and others to report C auris cases, or suspected cases, to state and local health departments and the CDC. Seven such US cases occurred between May 2013 and August 2016.

All patients had serious underlying medical conditions, including bone marrow transplantation. Four patients, all of whom had bloodstream infections, died during the weeks to months after C auris was identified.

The U.S.  isolates were related to isolates from South America and South Asia, although available epidemiologic information suggests that most were acquired in the United States. Several findings suggested that transmission occurred in US health care settings.

Five isolates were resistant to fluconazole; 1 of those was resistant to amphotericin B and another to echinocandins. No isolate was resistant to all 3 classes of antifungal medications.

To reduce the risk of transmission, the CDC advises using Standard and Contact Precautions for patients colonized or infected with C auris. Facilities should ensure thorough daily and terminal cleaning of patients’ rooms with an EPA-registered disinfectant with a fungal claim. In nursing homes, providers should consider the level of patient care being provided and the presence of transmission risk factors when deciding on the level of precautions. When patients are transferred, receiving facilities should be notified of the presence of this multidrug-resistant organism to ensure continuity of precautions.

Five of 7 reported isolates were either misidentified initially as C haemulonii or not identified beyond Candida spp. The CDC urges local and state health departments to continue to report possible cases of C auris and of isolates of C haemulonii and Candida spp. that cannot be identified after routine testing.

In 2009, Candida auris, an emerging invasive multidrug-resistant fungus, was isolated from external ear canal discharge of a patient in Japan. Since then, at least a dozen countries, including India, Israel, South Korea, and the United Kingdom, have published reports of C auris infections.

The emergence of C auris raises several serious concerns for public health, according to Morbidity and Mortality Weekly Report: Many isolates are multidrug-resistant; some strains have elevated minimum inhibitory concentrations to drugs in all 3 major classes of antifungal medications—a feature not found in other clinically relevant Candida species. Second, it’s challenging to identify, requiring specialized methods. C auris is often misidentified as other yeasts (most commonly Candida haemulonii). Finally, C auris has caused outbreaks in health care settings.

In June 2016, the CDC issued a clinical alert asking clinicians, public health authorities, and others to report C auris cases, or suspected cases, to state and local health departments and the CDC. Seven such US cases occurred between May 2013 and August 2016.

All patients had serious underlying medical conditions, including bone marrow transplantation. Four patients, all of whom had bloodstream infections, died during the weeks to months after C auris was identified.

The U.S.  isolates were related to isolates from South America and South Asia, although available epidemiologic information suggests that most were acquired in the United States. Several findings suggested that transmission occurred in US health care settings.

Five isolates were resistant to fluconazole; 1 of those was resistant to amphotericin B and another to echinocandins. No isolate was resistant to all 3 classes of antifungal medications.

To reduce the risk of transmission, the CDC advises using Standard and Contact Precautions for patients colonized or infected with C auris. Facilities should ensure thorough daily and terminal cleaning of patients’ rooms with an EPA-registered disinfectant with a fungal claim. In nursing homes, providers should consider the level of patient care being provided and the presence of transmission risk factors when deciding on the level of precautions. When patients are transferred, receiving facilities should be notified of the presence of this multidrug-resistant organism to ensure continuity of precautions.

Five of 7 reported isolates were either misidentified initially as C haemulonii or not identified beyond Candida spp. The CDC urges local and state health departments to continue to report possible cases of C auris and of isolates of C haemulonii and Candida spp. that cannot be identified after routine testing.

In 2009, Candida auris, an emerging invasive multidrug-resistant fungus, was isolated from external ear canal discharge of a patient in Japan. Since then, at least a dozen countries, including India, Israel, South Korea, and the United Kingdom, have published reports of C auris infections.

The emergence of C auris raises several serious concerns for public health, according to Morbidity and Mortality Weekly Report: Many isolates are multidrug-resistant; some strains have elevated minimum inhibitory concentrations to drugs in all 3 major classes of antifungal medications—a feature not found in other clinically relevant Candida species. Second, it’s challenging to identify, requiring specialized methods. C auris is often misidentified as other yeasts (most commonly Candida haemulonii). Finally, C auris has caused outbreaks in health care settings.

In June 2016, the CDC issued a clinical alert asking clinicians, public health authorities, and others to report C auris cases, or suspected cases, to state and local health departments and the CDC. Seven such US cases occurred between May 2013 and August 2016.

All patients had serious underlying medical conditions, including bone marrow transplantation. Four patients, all of whom had bloodstream infections, died during the weeks to months after C auris was identified.

The U.S.  isolates were related to isolates from South America and South Asia, although available epidemiologic information suggests that most were acquired in the United States. Several findings suggested that transmission occurred in US health care settings.

Five isolates were resistant to fluconazole; 1 of those was resistant to amphotericin B and another to echinocandins. No isolate was resistant to all 3 classes of antifungal medications.

To reduce the risk of transmission, the CDC advises using Standard and Contact Precautions for patients colonized or infected with C auris. Facilities should ensure thorough daily and terminal cleaning of patients’ rooms with an EPA-registered disinfectant with a fungal claim. In nursing homes, providers should consider the level of patient care being provided and the presence of transmission risk factors when deciding on the level of precautions. When patients are transferred, receiving facilities should be notified of the presence of this multidrug-resistant organism to ensure continuity of precautions.

Five of 7 reported isolates were either misidentified initially as C haemulonii or not identified beyond Candida spp. The CDC urges local and state health departments to continue to report possible cases of C auris and of isolates of C haemulonii and Candida spp. that cannot be identified after routine testing.