Active C. auris screening strategy reduced health care-associated transmission
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Key takeaways:
- Patients from nursing homes had the highest rates of testing while those from LTAC facilities had the highest positivity.
- Only two patients with internal transmission were identified following implementation.
SAN ANTONIO — An active screening strategy allowed patients with Candida auris to be rapidly identified and isolated to reduce risk of transmission in a health care facility, researchers reported.
“Over the last 3 to 4 years, Candida auris has become more apparent in high-risk settings,” Teresa York, BS, CIC, supervisor in the University of Texas Medical Branch department of infection control and health care epidemiology, said during a presentation at the APIC 2024 meeting.
“The University of Texas Medical Branch (UTMB), saw its first case in late 2021 that came from a high-risk setting. In response to identifying C. auris in our area, UTMB took a proactive approach to identify C. auris colonizers by implementing a screening program,” she said.
According to York, this program, which was launched in February 2022, was the product of several departments within the system — registration, nursing, the EMR informatics department and infection prevention — working together to identify patients upon registration, flagging their chart and alerting the physician to order a screening. She explained that the nurse receives a task to swab the patient bilateral axilla and groin, while infection prevention monitors the patient and follows up.
“These patients are placed in isolation until their test results are final,” York said. “If the patient is negative, then isolation will be removed. If the results are positive, the patient is placed on extreme drug-resistant organism (XDR) isolation indefinitely.”
Over a 21-month time frame, 3,508 high risk patients were tested, with 2.7% of these patients testing positive for C. auris.
According to the study, patients from nursing homes contributed the highest number of patients being tested (83%), followed by skilled nursing facilities (7%), rehab facilities (7%), and long-term acute-care (LTAC) facilities (3%).
The highest rates of positive test results came from patients from LTAC facilities (11.5%), followed by those from skilled nursing facilities (2.9%), nursing homes (2.4%), and rehab facilities (1.6%).
Throughout the study, only two patients with clinical infection considered to be internal transmission were identified. The researchers noted that both of these patients had a direct link to a confirmed C. auris patient.
York concluded, “Our proactive strategy of screening and isolating C. auris patients has been effective at control of transmission of C. auris infections in our inpatient setting.”
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York T, et al. Poster 117. Presented at: APIC 2024; June 3-5, 2024; San Antonio (hybrid).
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