Candida Auris Outbreak Investigation

Abstract

<h3>Background</h3> Candida auris (C. auris) is an emerging pathogen that can be multidrug resistant and has a high mortality rate. It is easily transmissible and extremely persistent in health care environments and has resulted in multiple outbreaks worldwide. Our hospital experienced a C. auris outbreak on an intensive care unit, which resulted in over 20 transmissions to patients. Here we describe our experience with this outbreak and steps implemented to control it. <h3>Methods</h3> An epidemiologic map was constructed to identify the source of the outbreak. The outbreak was traced back to a patient who was admitted a few months prior to the intensive care unit. The following measures were implemented: creation of an incident command structure, screening of all patients on the index unit and any unit with positive cases, screening of all patients transferred from active outbreak units, education for team members on horizontal measures, and implementation of standard work for cleaning measures. Cohort units were established for patients who were colonized with C. auris. <h3>Results</h3> Exposure screening on the index unit led to the identification of seven additional inpatient units as potential areas of risk. Weekly point prevalence screening of all patients on these units was initiated. During the time-period of August to November 2021, 440 screens were performed and 23 resulted positive (5.2% positivity rate). <h3>Conclusions</h3> Candida auris has the potential to persist in healthcare settings and can live in the environment for a long time. Prospective surveillance of at-risk patients is crucial to prevent the spread of this pathogen in our healthcare system. Rapid identification of cases and response to outbreaks requires a multidisciplinary effort and strict adherence to horizontal infection prevention methods to avoid resurgence of this pathogen in the environment.