The Importance of Information Technology and Surveillance to Prevent the Spread of Candida Auris

Abstract

Background : The importance of Information Technology (IT) and the collaboration with Infection Prevention (IP) is crucial to prevent the spread of emerging infections. Candida auris (C. auris) is a novel multidrug resistant species known to persist on surfaces and can lead to outbreaks at healthcare facilities. Most recently, in June 2020, C. auris outbreaks have occurred throughout skilled nursing facilities in Southern California. As an emerging infection, the novelty of in-house PCR for C. auris was essential to implement IT and IP approaches for early detection. This abstract describes the protocol our facility implemented to address this emerging infection through proactive surveillance and interfacility communication. Methods : Each admission included a C. auris risk assessment. For positive screenings, IT developed a nurse guided protocol to place C. auris surveillance and isolation orders. For patients with a history of C. auris, IP was automatically paged. IP placed the C. auris status in the patient chart triggering an automatic hold. The IT implemented automatic hold stopped the After Visit Summary from being printed until IP was notified, therefore preventing discharge of the patient until the Department of Public Health (DPH) was notified. Upon patient expiration, IP received an automatic page to notify DPH. Results : Since July 2020, 52 patients were tested for C. auris with 11 resulting positive. Due to early identification of high-risk factors for C. auris, the patients were placed in isolation to prevent possible transmission. Screening and isolation prevented hospital acquired C. auris infections at the facility. The forced hold prompted notification to DPH to prevent community transmission. Conclusions : The collaboration amongst IP and IT, with active surveillance ordering and holds on the chart, prevented an outbreak at this facility. The implications of this is a multi-level notification system to monitor C. auris within the healthcare facility to prevent unknown transmission and potential outbreaks.