Hospital detects rise in C. auris during pandemic
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During the COVID-19 pandemic, a hospital in Washington, D.C., experienced an increase in patients colonized or infected with Candida auris, many of them recent transfers from a long-term care facility.
The cases underscore the need to isolate and screen high-risk patients for C. auris to prevent its spread, Navitha Woddor, DO, a PGY-2 in the pathology department at the George Washington University School of Medicine and Health Sciences, and colleagues said.
In research presented at ASM Microbe, they noted that the pandemic has strained resources for hospital infection prevention and control programs, which the Association for Professionals in Infection Control and Epidemiology said recently were already “underfunded and understaffed” even before the pandemic began.
C. auris has been a focus of hospital infection prevention and control since the CDC issued a clinical alert about it in 2016.
According to the most recent CDC data, there were 1,503 clinical cases of C. auris reported in the U.S. between March 2, 2021, and Feb. 28, 2022, with California, Florida, Illinois and New York reporting more than 200 each. Over the same time, targeted screening identified more than 3,900 additional patients who were colonized with C. auris.
Woddor and colleagues said C. auris was rarely detected at their hospital in the past, but 19 cases of the aggressive and naturally resistant fungus were identified between March 2020 and January 2022, including 14 patients who had been transferred from a single long-term care facility (LTCF).
Experts have identified nursing homes and LTCFs as important to the transmission of C. auris. In 2019, researchers reported an outbreak of more than 180 cases at nine LTCFs or skilled nursing facilities in Southern California that they said was likely driven by interfacility transfers.
According to Woddor and colleagues, patients transferred from the LTCF to their hospital were isolated and screened for C. auris.
Among the 19 colonized patients included in the study — including the 14 LTCF transfers and four patients who were recent inpatients at another hospital — C. auris was detected in six blood, three respiratory, three urine, three wound and 10 skin surveillance specimens.
Nine patients from the LTCF were also colonized or infected with multidrug-resistant bacteria, mostly commonly Pseudomonas aeruginosa. Two patients tested positive for SARS-CoV-2.
All six C. auris isolates tested for antifungal susceptibility were resistant to fluconazole and susceptible to anidulafungin and micafungin, the researchers reported. Two of the isolates were resistant to both caspofungin and amphotericin.
References:
CDC. Screening for Candida auris colonization. https://www.cdc.gov/fungal/candida-auris/c-auris-screening.html. Accessed June 10, 2022.
CDC. Tracking Candida auris. https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html. Accessed June 10, 2022.
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Woddor N, et al. Abstract 2742. Presented at: ASM Microbe; June 9-13, 2022; Washington, D.C.
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