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March 27, 2024
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Less than half of surveyed facilities report performing C. auris screening

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Key takeaways:

  • Of more than 250 survey respondents from around the U.S., only 37% reported conducting C. auris screening.
  • Among those who reported screening, 75% reported at least one C. auris case in the last year.

Reported rates of Candida auris screening at facilities across the U.S. were low despite many facilities that conducted screening reporting at least one case of C. auris in the last year, according to survey results.

“Identifying patients colonized with C. auris through screening helps guide infection prevention and control strategies and can help prevent spread in health care facilities. At CDC, we recommend C. auris colonization screening based on epidemiological conditions and facility- and patient-level risk factors,” Ian P. Hennessee, PhD, MPH, an Epidemic Intelligence Service fellow in the CDC’s Mycotic Diseases Branch, told Healio.

IDN0324Hennessee_Graphic_01_WEB
Data derived from Hennessee IP, et al. Infect Control Hosp Epidemiol. 2024;doi:10.1017/ice.2024.5.

“However, we did not have much data about whether and how hospitals across the country were conducting C. auris screening. We also wanted to know whether screening practices varied based on local C. auris prevalence and how frequently facilities reported detecting new colonized cases through screening,” he said.

To gather these data, Hennessee and colleagues surveyed a U.S.-based network of infectious disease practitioners about screening practices in their facilities. The survey was sent in August 2022 to Infectious Diseases Society of America Emerging Infections Network subscribers on three separate occasions.

According to the study, the survey included questions asking whether screening was performed in the respondent’s facility, whether patients were screened on admission or once they were already in the facility, laboratory methods used for screening, numbers of screening tests conducted and C. auris cases detected in the prior year.

Responses were then grouped by region within each state and compared between regions considered “tier 3 or 4” where C. auris is frequently identified or tier 2 where it is not frequently identified.

In total, 253 responses were received — 119 (47%) from tier 3 or 4 areas and 134 (53%) from tier 2 areas. Of all respondents, 37% reported that C. auris screening was conducted at their facility, with more screening reported from tier 3 or 4 areas compared with tier 2 (59% vs. 17%). Among facilities that reported screening, 77% reported screening on admission and 51% reported screening patients already in the facility.

The study also demonstrated that among 68 respondents who reported screening and had complete responses for the number of patients screened and cases detected, 75% reported detecting at least one C. auris case in the last year (87% from tier 3 or 4 facilities vs. 38% from tier 2 facilities), whereas 37% reported having identified at least five cases (40% from tier 3 or 4 facilities, 25% from tier 2 facilities).

“These findings suggest opportunities to increase C. auris screening across U.S. facilities,” Hennessee said. “In tier 3 or 4 areas where C. auris is already common, increased screening of patients already in the facility (eg, by performing point prevalence surveys) could help detect transmission and guide measures to limit spread. In tier 2 areas where C. auris is not yet common, increased adoption of targeted admission screening could help detect new introductions and guide containment measures before spread begins.”

He concluded, “Overall, increasing screening could help prevent the spread of C. auris in health care facilities throughout the U.S.”