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15 INFECTION CONTROL & PATIENT SAFETY First Cases of Deadly Fungal Infection Reported in US: 8 Things to Know By Heather Punke I n June 2016, the CDC issued a warning to hospitals about an emerging, deadly yeast infection making its way across the globe. In November, local and state health depart- ments and the CDC announced 13 cases of Candida auris infections had been identi- fied in the U.S. Here are eight things to know about C. au- ris and the newly reported U.S. cases. 1. Many C. auris isolates are resistant to multiple antifungal drugs, with some strains showing resistance to all three major classes of antifungal medications. e fungus is diffi- cult to identify and is oen mistaken for oth- er, less-dangerous Candida strains. 2. e yeast has caused outbreaks in health- care settings (like a recent outbreak in Lon- don) and is present in several countries, including Japan, Colombia, India, Israel, Kenya, Kuwait, Pakistan and others. 3. In June, the CDC issued a warning about the yeast and asked labs in the U.S. to re- port C. auris cases and send samples to the CDC. Since then, 13 cases have been identi- fied. Seven of the cases were described in a CDC's Morbidity and Mortality Weekly Re- port, but the other six were identified aer the period covered by the report. 4. e seven cases were identified between May 2013 and August 2016 in four states: New York, Illinois, Maryland and New Jersey. Four of those patients died, but it is unclear if their deaths were associated with the C. au- ris infection, as they all had serious underly- ing medical conditions. 5. In two instances, two patients were treat- ed at the same healthcare facility and their C. auris strains were nearly identical. 6. Most of the C. auris strains in U.S. patients (71 percent) had some sort of drug resis- tance, but none of them were resistant to all three antifungal drug cases. Most of the sam- ples seemed to be related to C. auris strains from South Asia and South America, but the effected patients had not traveled to that area, meaning they likely acquired the infection locally. 7. e CDC recommends hospitals imple- ment Standard and Contact Precautions to prevent the spread of the yeast in their facili- ties. In rooms where a C. auris patient is dis- charged, workers should use an Environmen- tal Protection Agency-registered disinfectant active against fungi. 8. "We need to act now to better understand, contain and stop the spread of this drug-re- sistant fungus," said CDC Director Tom Frie- den, MD. "is is an emerging threat, and we need to protect vulnerable patients and others." n Infectious Disease Death Trends in the US: 8 Key Points By Heather Punke I nfectious diseases were responsible for 5.4 percent of deaths in the U.S. from 1980 through 2014, though the top-killing diseases changed throughout that 34-year span, according to research published in JAMA. Researchers used ICD codes to pull infectious disease mortality data from the National Office of Vital Statistics from 1900 through 1967 and from the CDC WONDER da- tabase from 1968 through 2014. Here are eight things to know about deaths in the U.S. from infectious diseases, pulled from their report. 1. From 1900 through 1950, infectious disease mortality in the U.S. generally declined, except for a spike in 1918, thanks to the Spanish flu. According to the CDC, the Spanish flu pandemic of 1918-19 killed anywhere be- tween 50 million and 100 million people worldwide. 2. After 50 years of general decline, infectious disease mortality leveled off after 1950. Even though mortality from infectious disease has remained somewhat stable since then, some new and emerging infectious diseases created mortality spikes from 1980 through 2014. 3. For instance, infectious disease mortality per 100,000 people rose from 42 in 1980 to 63.5 in 1995 because of the spread of HIV/AIDS, according to the study. However, after antiretroviral therapy was introduced, mortality again declined. 4. After West Nile virus was introduced in 2000 in the U.S., mortality due to vector-borne diseases increased from 0.01 per 100,000 people (from spotted fevers) to 0.05 per 100,000 population. 5. Hepatitis B mortality increased at a rate similar to that of HIV/AIDS in the 1980s and 1990s: In 1980, hepatitis B mortality was 0.13 per 100,000 people. In 1995, it grew to 0.39. 6. Clostridium difficile deaths used to almost be nonexis- tent — mortality was 0.004 per 100,000 in 1989. But C. diff mortality exploded since then, reaching a plateau of 2.4 per 100,000 in 2007. 7. Despite those emerging infectious diseases, influenza and pneumonia remain the deadliest infectious diseases in the U.S., according to the research. They accounted for roughly 40 percent of infectious disease mortality from 1980 through 2014. 8. "These trends illustrated the continued U.S. vulnerability to infectious diseases," the study concluded. n