Detroit hospital stops admitting patients to control rare fungus outbreak

A Detroit hospital will stop taking patients temporarily as it tries to contain an outbreak of a rare, but potentially deadly and drug-resistant fungus.

Candida auris is a yeast that can live on a healthy person without making them ill, and it’s not a threat to the general public and otherwise healthy people, said Dr. Natasha Bagdasarian, chief medical executive at the Michigan Department of Health and Human Services.

But carriers — who are considered “colonized” with the fungus  — can then spread the fungus to more vulnerable individuals, where it can trigger fatal infections. Particularly vulnerable are those who require ventilators and other medical equipment.

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None of the cases at Select Specialty Hospital – Northwest Detroit on Outer Drive have been fatal, according to MDHHS. And two patients have fully recovered from the fungus and been discharged, Shelly Eckenroth, spokesperson for Select Medical, told Bridge Michigan.

But C. auris represents a worrying trend as it adds to a growing list of drug-resistant pathogens, the state’s Bagdasarian said.

An increasing reliance on antibiotics throws off the delicate microbiome of bacteria and yeasts that beneficially live with humans both inside and outside the body, allowing dangerous microorganisms to emerge and flourish, she said.

“It is an emerging pathogen, and it has the potential to be multi-drug resistant,” she said, calling drug-resistant pathogens a “next threat” as the world emerges from the COVID-19 pandemic.

C. auris is part of a species of candida that also causes thrush, urinary tract infections and vaginal yeast infections. But the fungus is deadly in bloodstream infections, killing about one in four infected hospitalized patients, according to the U.S. Centers for Disease Control and Prevention.

C. auris, in particular, has proven resistant to antifungal medicines that are commonly used.

The fungus was first identified in 2009 in Japan, but didn’t show up in Michigan until this past October, according to MDHHS. (It was made a “reportable” disease by the CDC in 2016.)

The first Michigan cases were sporadic, and the Detroit cluster of seven cases, first detected in March, marks the first considered an “outbreak,” Bagdasarian told Bridge.

Elderly and very sick patients in hospitals and residents in nursing homes are particularly vulnerable to C. auris, which spreads from the body to other people or on equipment and other surfaces, according to the CDC.

Specialty Select is a national chain of 134 hospitals specializing in “chronically ill, medically-complex” patients being discharged from local intensive care units, often on ventilators and too sick to return home or go to a skilled nursing facility, said Eckenroth, the spokesperson.

The 36-bed Detroit site leases space on the seventh floor of Sinai-Grace Hospital, but is not affiliated with Detroit Medical Center, according to an email to Bridge from DMC spokesperson Brian Taylor.

Patients in the Detroit hospital outbreak ranged in age from 58 to 81, according to Lynn Sutfin, MDHHS spokesperson.

Select Specialty paused patient admissions starting Wednesday, and it continues to work with the state and Detroit Detroit health departments to identify the source of the outbreak, Eckenroth said.

The recovery hospital draws patients from several hospitals, she said, noting a “good chance” that the fungus came from one of those transfers. In fact, the earlier cases all were in southeast Michigan, said Sutfin at MDHHS.

The facility also has stepped up its hand hygiene practices, the use of personal protective equipment and deep cleaning of high-touch surfaces and medical equipment, using disinfectants effective against C. auris. 

It also will screen patients for C. auris prior to discharge and conduct facility-wide auris screening of all patients at least once every two weeks, according to the state.