'Japanese fungus' outbreak hits London hospitals

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The outbreak of a potentially deadly fungus at a major London hospital was blamed on “low nursing levels”, the Standard can reveal.

A total of 31 patients were colonised with the so-called “Japanese fungus” Candida auris at King’s College hospital, in Denmark Hill, after it was passed on from a woman patient admitted from the Royal Brompton, the specialist heart and lung hospital in Chelsea, in April 2016.

Today it emerged that more than 200 patients in 20 NHS trusts and private hospitals had been affected, with the intensive care units at the two London hospitals among the worst affected.

The outbreak at King’s lasted a year and only ended in April. In six cases, the fungus entered the bloodstream, causing an infection.

Board papers for the hospital’s parent NHS trust in March stated: “While the trust is implementing infection prevention and control protocols, it was noted that the spread of the pathogen is affected by low nursing levels.”

Candida auris was first detected in the ear of a patient in Japan in 2009 and has been reported sporadically in England since 2013. 

The rare fungus, or yeast, lives on the skin or inside the body. Some patients carry it without becoming unwell but it can cause infections if it gets into surgical wounds or when urinary catheters or drips are inserted. 

Last year the US warned that the fungus, which has a high mortality rate and is resistant to infection control measures, was spreading in US health facilities. 

Public Health England, which this week updated its guidance on dealing with an outbreak, said it appeared to be “highly transmissible” between patients but none of this country’s cases had proved fatal.

Patients who develop an infection are normally isolated but King’s said it had problems identifying it quickly and finding single rooms. Laboratory tests took “eight to nine days”.

Across the NHS, 35 patients known to be carrying the fungus have been transferred between hospitals. A pilot scheme testing all patients admitted to intensive care was launched in five hospitals last month. 

About a quarter of detections have been clinical infections, including 27 patients who developed blood stream infections, Public Health England said. It recommends washing patients with chlorohexidine, a disinfectant used before surgery, to treat colonisation.

Kings said its critical care units, liver and cardiac wards were the worst hit. Board papers revealed: “The first case was a patient admitted from the Royal Brompton in April 2016 who was known to be positive on admission and isolated in a side room on the critical care unit and cardiac wards during her hospital stay.”

The Brompton, which is believed to have been the worst affected hospital in the country, was unable to say how many patients were affected.


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