Controlling a possible outbreak of Candida auris infection: lessons learnt from multiple interventions

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Microbiology

Background:

• Multidrug-resistant Candida auris is a growing global health concern, with rapid transmission noted in healthcare settings.
• High prevalence of invasive C. auris infections reported in intensive care units, particularly in India.
• Understanding intra-hospital transmission dynamics is crucial for effective control strategies.

Observation:

• Surveillance in intensive care units monitored patient colonization, environmental contamination, and healthcare worker hand carriage of C. auris.
• Interventions included patient chlorhexidine washing and environmental surface decontamination using stabilized hydrogen peroxide.
• Effectiveness of hospital disinfectants against C. auris on various surfaces and its persistence on fabrics were evaluated.

Findings:

• Three cases of C. auris bloodstream infection identified over three months, with evidence of patient colonization and environmental contamination.
• C. auris was detected on environmental surfaces and healthcare worker hands, indicating multiple transmission routes.
• Chlorhexidine washing and appropriate disinfectant use successfully eradicated C. auris from patients and the hospital environment.

Implications:

• Standard hospital disinfectants and hand hygiene practices are effective against C. auris when protocols are strictly followed.
• C. auris can persist on dry hospital fabrics for up to seven days, highlighting the need for thorough decontamination.
• Effective infection control measures are essential to prevent the spread of multidrug-resistant C. auris in healthcare facilities.