High Prevalence of Candida auris Colonization during Protracted Neonatal Unit Outbreak, South Africa

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Public Health

Background:

• Candida auris is an emerging multidrug-resistant fungal pathogen causing outbreaks globally.
• Neonatal units are vulnerable to Candida auris colonization and infection due to susceptible patient populations.
• Outbreaks of Candida auris necessitate rapid detection and effective control strategies.

Purpose of the Study:

• To assess Candida auris colonization prevalence during an outbreak in a South African neonatal unit.
• To evaluate the sensitivity of direct PCR for rapid Candida auris colonization detection compared to traditional culture methods.
• To determine the impact of infection control interventions on Candida auris incidence.

Main Methods:

• A point-prevalence survey was conducted in a neonatal unit during a Candida auris outbreak.
• Direct PCR and fungal culture were used to detect Candida auris colonization.
• Infection incidence rates were monitored before and after the implementation of isolation and cohorting protocols.

Main Results:

• One-third of neonatal patients surveyed were colonized with Candida auris.
• Direct PCR demonstrated a sensitivity of 44% for detecting colonization when compared to culture.
• Following the implementation of isolation and cohorting, the Candida auris infection incidence rate decreased by 85%.

Conclusions:

• Candida auris colonization was prevalent in the neonatal unit during the outbreak.
• Direct PCR showed limited sensitivity for rapid colonization detection in this setting.
• Effective infection control measures, including isolation and cohorting, significantly reduced Candida auris infection rates.