Infectious Disease

Preventive measures stopped C. auris outbreaks in two California hospitals

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Jefferson EA. Preventing an outbreak of Candida auris in an acute hospital during the COVID-19 pandemic. Presented on: APIC 2021; 28.-30. June 2021 (virtual meeting).

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Jefferson, Parti and Walton do not report any relevant financial information. Please refer to the studies for all relevant financial information from the other authors.

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Two California hospitals explained how they were using preventative measures to successfully stop the spread of Candida auris.

Experts summarized the answers at the annual meeting of the professional association for specialists in infection control and epidemiology. Related studies have also been published in the American Journal of Infection Control

Elizabeth Jefferson

Infection Prevention Service is in place to prevent a possible C. auris outbreak at Scripps Memorial Hospital in La Jolla Elizabeth Anne Jefferson, PhD, CIC, and colleagues tagged and isolated a patient who tested positive for the pathogen. Jefferson told Healio that it is important to identify C. auris as early as possible, as nearly a third of isolates show multiple resistance.

“Clinically, this means that first-line antifungal treatment could fail and treatment options could be very limited,” said Jefferson. “It is important for clinicians to know if their laboratory can identify C. auris, and if not, isolates need to be sent to other laboratories that can identify it. It is also important to have C. auris susceptibility tests to guide antifungal therapy. The susceptibility to C. auris drugs can vary greatly depending on the region of origin. “

Jefferson and colleagues first identified a patient hospitalized abroad with C. auris through the hospital’s screening program for carbapenemase-producing organisms. To prevent further spread, they kept the patient in isolation for 47 days and imposed cleaning measures, including the use of disinfectants and ultraviolet light to clean the patient’s rooms. No C. auris colonization or clinical isolates were found in the following 6 months.

“It is important to know the patient’s risk factors for C. auris. Risk factors include patients who have received medical care outside of the United States, particularly in countries where C. auris is prevalent, ”Jefferson said. “Ventilated patients who are transferred from long-term acute care facilities or from qualified care facilities are also at risk. Patients who do not respond to empirical antifungal therapy and from whom an atypical or unidentified yeast is isolated are at a particularly high risk for C. auris. “

In the summer of 2020, an existing notification system helped prevent another potential C. auris outbreak at the University of California Los Angeles Health.

Urvashi Drive off

Shaunte C. Walton

Urvashi Drive off, MPH, a health care provider, and Shaunte C. Walton, MS, CIC, The director of clinical epidemiology and infection prevention of the health system told Healio that the results of their analysis underscore the “importance of active surveillance testing” in containing the spread of emerging diseases.

“The collaboration of active monitoring tests together with multilevel notifications in the

electronic medical records prevented cross-contamination in healthcare, ”they said. “Proactively identifying high-risk factors for an emerging infection will prevent transmission when appropriate steps such as testing, isolation, and effective disinfection are taken.”

UCLA infection prevention experts used their EMR system to screen every incoming patient for COVID-19 and C. auris. High risk patients were flagged and tested, and notifications were sent to infection prevention, the laboratory, environmental services, and nursing staff.

A total of 11 of 52 patients tested positive for C. auris and were isolated.

Walton and Parti said one of the study’s main limitations was the lack of previous research on C. auris.

“As the number of C. auris cases increases across the county, more analysis will be available,” they said.

California is one of four US states that reported more than 100 clinical cases of C. auris between May 1, 2020 and April 30, 2021, according to the CDC.

References:

Jefferson EA. Am J infection control. 2021; doi: 10.1016 / j.ajic.2021.04.042.

Jefferson EA. Preventing an outbreak of Candida auris in an acute hospital during the COVID-19 pandemic. Presented on: APIC 2021; 28.-30. June 2021 (virtual meeting).

Party U et al. Am J infection control. 2021; doi: 10.1016 / j.ajic.2021.04.032.

PartiU et al. The importance of information technology and surveillance in preventing the spread of candida auris. Presented on: APIC 2021; 28.-30. June 2021 (virtual meeting).

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Association for Professionals in Infection Control and Epidemiology Annual Conference

Association for Professionals in Infection Control and Epidemiology Annual Conference

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