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Published on: March 22, 2024
Infection prevention and control of Candida auris in pediatric settings
Thomas S Murray1,2, Hana Hakim3, Christelle Ilboudo4,5
1Yale New Haven Children's Hospital, New Haven, CT, USA.
Insights
New guidelines offer infection prevention and control (IPC) strategies for Candida auris (C. auris) in pediatric settings. These recommendations address critical gaps in care for this multidrug-resistant fungus.
Area of Science:
- Fungal Pathogenesis
- Infectious Disease Epidemiology
- Public Health
Background:
- Candida auris is an emerging multidrug-resistant fungal pathogen causing significant morbidity and mortality.
- Current infection prevention and control (IPC) guidance primarily targets adult populations, lacking specific recommendations for pediatric settings.
- There is a critical need for tailored IPC strategies for Candida auris in diverse pediatric environments.
Purpose of the Study:
- To develop evidence-based IPC recommendations for Candida auris in pediatric healthcare and non-healthcare settings.
- To address the unique challenges and risk factors associated with pediatric populations.
- To provide a practical framework for preventing Candida auris transmission in children.
Main Methods:
- A multidisciplinary expert panel convened by the Society for Healthcare Epidemiology of America (SHEA) developed the recommendations.
- A structured, iterative Delphi consensus process involving discussion, refinement, and anonymous voting was employed.
- Panelists synthesized peer-reviewed literature, gray literature, expert judgment, and practical considerations.
Main Results:
- The consensus statement provides comprehensive recommendations for preventing Candida auris in pediatric acute care, non-acute healthcare, and non-healthcare congregate settings.
- Recommendations cover screening, isolation, caregiver-infant/child dyads, rooming, breastfeeding, visitation, shared spaces, environmental cleaning, and equipment management.
- Emphasis is placed on integrating pediatric-specific needs and coordinating with public health partners.
Conclusions:
- This SHEA consensus statement fills a crucial gap in pediatric-specific IPC guidance for Candida auris.
- The recommendations offer a practical framework to prevent Candida auris transmission in pediatric care.
- The guidance supports family-centered care while addressing clinical and developmental considerations in children.
Background:
Candida auris (also referred to as Candidozyma auris) is an emerging multidrug-resistant fungal pathogen associated with high morbidity and mortality. Existing infection prevention and control (IPC) guidance has largely focused on adult populations, with limited recommendations for pediatric healthcare and non-healthcare settings.
Methods:
The Society for Healthcare Epidemiology of America (SHEA) convened a multidisciplinary expert panel to develop IPC recommendations for C. auris. The panel developed recommendations using a structured, iterative Delphi consensus process with rounds of discussion, refinement, and anonymous electronic voting with predefined consensus thresholds. Panelists reviewed relevant peer-reviewed and gray literature integrated with expert judgment and practical considerations. Preambles and remarks provide additional context and guidance.
Results:
This consensus statement provides recommendations for prevention of C. auris in pediatric acute care settings, non-acute healthcare settings, and non-healthcare congregate settings. Recommendations incorporate pediatric risk factors and care and address screening practices, isolation precautions, caregiver-infant/child dyad considerations, room placement and rooming in, breastfeeding and skin-to-skin practices, visitation, use of shared spaces, environmental cleaning and disinfection, and management of medical and non-medical equipment, including toys. Recommendations emphasize coordination with local infection prevention and public health partners.
Conclusions:
This SHEA consensus statement addresses gaps in pediatric-specific IPC guidance for C. auris. The recommendations provide a practical framework to support prevention of transmission within the context of pediatric clinical, developmental, and family-centered care.
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