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Prevention of Candida Auris Outbreak

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      Background

      Candida auris (C. auris) is an emerging, multidrug-resistant fungus. Because of the difficulty of identification of this organism and its ability to spread through patient contact and environmental contamination, healthcare settings are experiencing outbreaks with this organism.

      Methods

      The Health Department (HD) contacted Infection Prevention (IP) regarding an admitted patient who had been exposed to C. auris during a hospitalization at another facility. The patient had been admitted for 5 days without isolation. The HD requested we isolate and screen the patient for C. auris. The patient was found to be colonized with C. auris. An exposure investigation was implemented. Because part of the patient's stay was on an Inpatient Rehabilitation unit, we categorized exposure risks to high and low. Patients at high risk were placed on Contact Isolation in a private room whereas patients at low risk were placed on modified Contact Isolation and were cohorted. Additionally, all affected areas were disinfected with bleach. Patients transferred from our facility to our sister facilities were screened. Patients discharged prior to screening were flagged in our IP software to be identified upon readmit for isolation and screening. We also partnered with the HD and other facilities where our patients were transferred for prevention of spread.

      Results

      A total of 104 patients were determined to be exposed. Thirty-one patients were screened with no new cases identified. Other exposed patients who were discharged from our hospital screened elsewhere were found to be negative.

      Conclusions

      Having adequate laboratory technology to identify this organism is critical to the interruption of spread. Timely notification of a potential case is important to decrease the scope of exposure. Practicing effective hand hygiene and daily environmental disinfection with an agent that has activity against C. auris are also key strategies to prevent the spread of this significant organism.
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