ISR 86 - Targeted Candida Auris Surveillance to Reduce Transmission from Long Term Acute Care Hospitals

Background: Candida auris (C. auris), a multidrug-resistant fungus, is increasingly prevalent in the United States (U.S). C. auris can colonize patients’ skin and contaminate the environment, leading to healthcare transmission. Locally, many cases of C. auris have been reported in Long-Term Acute Care Hospitals (LTACHs). Following our acute care hospital’s first case, the Infection Prevention and Hospital Epidemiology team implemented strategies to reduce the likelihood of transmission within our facility, including auditing room cleaning and collecting targeted environmental surface and patient cultures. Herein we describe our experience with targeted surveillance for C. auris.

Methods: In March 2023, our hospital started performing surveillance skin cultures (axilla and groin) for C. auris in patients at high risk of C. auris colonization. We included those with reported environmental exposure and those with recent admissions to an LTACH, as most early cases of C. auris in our region were reported at these facilities. We created several reports within our electronic medical record to identify these patients, capturing bed tracing, hospital transfers, and patients' primary residencies.

Results: 11 surveillance cultures for C. auris were conducted from March 2023 through November 2023, 4 were due to environmental exposures and 7 from patients with recent admissions at an LTACH. All 4 cultures performed for environmental exposures were negative. Three of the 7 (43%) cultures performed from patients from LTACHs were positive. Those 3 were all from patients transferred from the same LTACH, from which 5 patients were cultured in total.

Conclusions: Targeted surveillance for C. auris colonization has proven to be a successful approach at our facility, in particular on patients transferring from LTACHs. As more data is collected the team will reassess this approach to determine whether to narrow or broaden our surveillance efforts.