EOC 09 - Dynamics of Candida auris Transmission and its Effective Containment in a Tertiary Health Care Setting of India

Background: Candida auris has emerged as a global health threat, with therapeutic failures, high mortality, the potential for rapid transmission, and hospital outbreaks. The study aims to describe the dynamics of its transmission in an Indian tertiary care setting over a four-year period, as well as infection control strategies that resulted in its successful containment.

Methods: A retrospective analysis was conducted on the isolation of C. auris among patients admitted to a tertiary care hospital in India between October 2020 and November 2023. The Hospital infection control team conducted a thorough epidemiological investigation for each incident case to identify the colonisation and risk factors in patients, as well as the extent of pathogen transmission to nearby patients and the environment through active surveillance. As a control measure, the infected patients were promptly placed under contact precautions, and the high touch surfaces were thoroughly cleaned and disinfected using an aldehyde-based disinfectant.

Results: During the study period, 33 cases of C. auris were reported, with a mean age of 49.32 ± 17.46 and 63% of males. The majority of patients (66.6%) were admitted to ICU and had C. auris-related bloodstream infections (66.6%). Spread to other patients and the nearby inanimate environment was observed in only four cases (12.12%) and 15.15% of objects, respectively. The rate of both environmental spread and cross transmission was significantly higher (p < 0.001) among colonised patients (50%) compared to non-colonized patients (7%). Average length of hospital stay of >15 days, presence of chronic kidney disease (80%) and diabetes (60%) in affected patients were the significant factors associated with transmission. The outbreak was effectively controlled in the remaining incidents (87.8%) due to prompt interventions.

Conclusions: C.auris transmission was very limited within the hospital and was associated with identifiable risk factors that can be effectively contained by implementing prompt and stringent infection control interventions.