Control of Candida auris Septicemia in Patients of Trauma Intensive Care Unit in a Tertiary Care Hospital

Abstract

Introduction: Candida auris is associated with nosocomial outbreaks in intensive care settings, and transmission despite the implementation of enhanced infection prevention and control (IPC) measures is a particular concern. Objective: Isolation and identification of C. auris from suspected cases of fungal septicemia and its surveillance. Materials and Methods: Blood culture samples of all suspected cases of fungal septicemia were taken from the trauma intensive care unit (TICU) of a tertiary care hospital in New Delhi between September 2019 and November 2019 as part of surveillance of device-associated infections. All the samples were obtained by central venous catheter line. Samples were processed in BacT/Alert automated blood culture system. Positive flagged bottles were further subcultured unto blood agar, MacConkey agar, and Sabouraud Dextrose Agar with and without cycloheximide and incubated at 37°C. All suspected Candida isolates were identified by conventional methods and the suspected C. auris isolates were further confirmed by matrix-assisted laser desorption time of flight. Results: Out of 24 suspected fungal septicemia cases from TICU, three patients had C. auris septicemia and all three isolates were resistant to fluconazole and voriconazole. Action Taken: IPC practices were reinforced as per the Centers for Disease Control and Prevention guidelines by the infection control team. Conclusion: This article depicts the emergence of multidrug-resistant C. auris and controlling its spread by appropriate infection control measures.