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Environmental Contamination with Candida Species in Multiple Hospitals Including a Tertiary Care Hospital with a
Jessica Kumar1, Brandon Eilertson2, Jennifer L Cadnum3
1Geriatric Research, Education, and Clinical Center; Louis Stokes Cleveland VA Medical; Cleveland, Ohio.
Background:
Environmental sources have been implicated as a potential source for exogenous acquisition of Candida species, particularly the emerging multidrug-resistant Candida auris. However, limited information is available on environmental reservoirs of Candida species in healthcare facilities.
Methods:
During a 6-month period, cultures for Candida species were collected from high-touch surfaces in patient rooms and from portable equipment in 6 US acute care hospitals in 4 states. Additional cultures were collected from sink drains and floors in one of the hospitals and from high-touch surfaces, portable equipment, and sink drains in a hospital experiencing an outbreak due to C. auris. Candida species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectometry.
Results:
Candida species were recovered from patient rooms in 4 of the 6 hospitals. Seven of 147 patient room cultures (4.8%) and 1 of 57 (1.8%) portable equipment cultures were positive, with the most common species being C. parapsilosis. For the hospital where additional sites were sampled, Candida species were recovered from 8 of 22 (36.4%) hospital room floors and 4 of 17 (23.5%) sink drains. In the facility with a C. auris outbreak, Candida species were frequently recovered from sink drains (20.7%) and high-touch surfaces (15.4%), but recovery of C. auris was uncommon (3.8% of high-touch surfaces, 3.4% of sink drains, and 0% of portable equipment) and only present in rooms that currently or recently housed a patient with C. auris.
Conclusion:
Candida species often contaminate surfaces in hospitals and may be particularly common on floors and in sink drains. However, C. auris contamination was uncommon in a facility experiencing an outbreak, suggesting that current cleaning and disinfection practices can be effective in minimizing environmental contamination.
Insights
Environmental contamination by Candida species is common in hospitals, especially on floors and drains. However, Candida auris contamination was infrequent during an outbreak, indicating effective disinfection practices.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Environmental reservoirs of Candida species, including multidrug-resistant Candida auris, are not well understood in healthcare settings.
- Understanding environmental contamination is crucial for infection control, particularly for emerging pathogens.
Purpose of the Study:
- To investigate the prevalence and distribution of Candida species on environmental surfaces in US acute care hospitals.
- To assess Candida contamination in a hospital experiencing a Candida auris outbreak.
Main Methods:
- Cultures for Candida species were collected from high-touch surfaces, portable equipment, sink drains, and floors across 6 US hospitals over 6 months.
- Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used for species identification.
Main Results:
- Candida species were recovered from patient rooms in 4 of 6 hospitals, with Candida parapsilosis being most common.
- Floors and sink drains showed higher contamination rates (36.4% and 23.5%, respectively) compared to high-touch surfaces (4.8%) and portable equipment (1.8%).
- In a Candida auris outbreak setting, contamination was frequent on sink drains (20.7%) and high-touch surfaces (15.4%), but Candida auris itself was uncommon (3.8% on high-touch surfaces, 3.4% on sink drains).
Conclusions:
- Candida species frequently contaminate hospital surfaces, particularly floors and sink drains.
- Candida auris contamination was limited in an outbreak setting, suggesting the efficacy of current cleaning and disinfection protocols.
- Environmental surveillance is important for understanding Candida reservoirs and guiding infection prevention strategies.
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