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Candidozyma auris Outbreak and Its Effective Control in a General Hospital
Flora V Kontopidou1, Maria Antonopoulou1, Anastasia Votsi2
1Infection Control Committee, Mitera General Hospital, 15123 Athens, Greece.
Abstract:
Background/Objectives:Candidozyma auris (C. auris) is a multidrug-resistant pathogen recognized as a serious global public health threat. Herein, we report a C. auris outbreak that was successfully contained in a general hospital located in Athens, Greece. Methods: This study was conducted between December 2021 and December 2023. Upon identification of the first imported case of C. auris, the following infection control measures were applied in a stepwise approach: the promotion of hand hygiene, contact precautions and isolation, chlorhexidine gluconate bathing of patients, enhanced environmental cleaning, and active surveillance cultures of all high-risk patients upon admission. Active surveillance cultures were performed weekly in non-colonized ICU patients. Results: A total of 1564 screening samples from 890 patients were analyzed. Sixty-three patients were identified to be colonized and three to be infected with C. auris. After implementing screening and enhanced environmental cleaning, the quarterly incidence of hospital-acquired cases decreased from 0.37 to 0.04 cases per 1000 patient-days (slope of linear trend: -0.08; 95% CI: -0.16 to -0.0004; p = 0.05), despite the continuous inflow of already colonized patients. Conclusions: A bundle of infection control measures, including active surveillance cultures upon admission and enhanced environmental cleaning, can contain C. auris dissemination in acute healthcare settings.
Insights
A combination of infection control strategies, including active surveillance cultures and enhanced environmental cleaning, successfully contained a Candida auris outbreak in a Greek hospital. This approach reduced hospital-acquired cases significantly, demonstrating effective control of this multidrug-resistant pathogen.
Area of Science:
- Infectious Diseases
- Public Health
- Hospital Epidemiology
Background:
- Candida auris is a multidrug-resistant fungus posing a significant global health threat.
- Nosocomial outbreaks of Candida auris require effective containment strategies in healthcare settings.
Purpose of the Study:
- To report the successful containment of a Candida auris outbreak in a general hospital in Athens, Greece.
- To evaluate the effectiveness of a bundle of infection control measures against Candida auris dissemination.
Main Methods:
- Implementation of a stepwise approach including hand hygiene, contact precautions, isolation, chlorhexidine bathing, and enhanced environmental cleaning.
- Active surveillance cultures for Candida auris upon admission and weekly for ICU patients.
- Analysis of 1564 screening samples from 890 patients over a two-year period.
Main Results:
- Sixty-three patients were colonized and three were infected with Candida auris.
- Quarterly incidence of hospital-acquired cases decreased from 0.37 to 0.04 cases per 1000 patient-days post-intervention.
- A statistically significant reduction in incidence was observed (p=0.05) despite ongoing admission of colonized patients.
Conclusions:
- A comprehensive bundle of infection control measures, including active surveillance and environmental cleaning, is effective in containing Candida auris.
- These strategies can limit the spread of multidrug-resistant organisms in acute care facilities.
- Successful outbreak containment is achievable through a coordinated and enhanced infection control program.
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