Rapid Assessment and Containment of Candida auris Transmission in Postacute Care Settings—Orange County, California, 2019
| العنوان: | Rapid Assessment and Containment of Candida auris Transmission in Postacute Care Settings—Orange County, California, 2019 |
|---|---|
| المؤلفون: | Sam Horwich-Scholefield, Lydia Mikhail, Elizabeth L. Berkow, Christopher Prestel, Ellora Karmarkar, Maroya Spalding Walters, Kara Jacobs-Slifka, Douglas K Schan, Sopheay Hun, Nimalie D. Stone, Nicole Gualandi, Jennifer L. Dale, Darby S McDermott, Snigdha Vallabhaneni, Matthew Zahn, Tyler Maruca, Sudha Chaturvedi, Teresa Nelson, Nancy A. Chow, Mitsuru Toda, Janet Glowicz, Hosniyeh Bagheri, Zenith Khwaja, Kathleen O’Donnell, Paula Snippes Vagnone, John Rossow, Annastasia Gross, Josh Jacobs, Ryan Ruiz, Emily Schneider, Liore Klein, Kaitlin Forsberg, Michele Cheung, Seema Jain, Brendan R Jackson, Lalitha Gade, Richard Brooks, Erin Epson |
| المصدر: | Annals of Internal Medicine. 174:1554-1562 |
| بيانات النشر: | American College of Physicians, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Transmission (medicine), business.industry, media_common.quotation_subject, Prevalence, Outbreak, General Medicine, Rapid assessment, Candida auris, Hygiene, Acute care, Emergency medicine, Internal Medicine, medicine, Infection control, business, media_common |
| الوصف: | BACKGROUND Candida auris, a multidrug-resistant yeast, can spread rapidly in ventilator-capable skilled-nursing facilities (vSNFs) and long-term acute care hospitals (LTACHs). In 2018, a laboratory serving LTACHs in southern California began identifying species of Candida that were detected in urine specimens to enhance surveillance of C auris, and C auris was identified in February 2019 in a patient in an Orange County (OC), California, LTACH. Further investigation identified C auris at 3 associated facilities. OBJECTIVE To assess the prevalence of C auris and infection prevention and control (IPC) practices in LTACHs and vSNFs in OC. DESIGN Point prevalence surveys (PPSs), postdischarge testing for C auris detection, and assessments of IPC were done from March to October 2019. SETTING All LTACHs (n = 3) and vSNFs (n = 14) serving adult patients in OC. PARTICIPANTS Current or recent patients in LTACHs and vSNFs in OC. INTERVENTION In facilities where C auris was detected, PPSs were repeated every 2 weeks. Ongoing IPC support was provided. MEASUREMENTS Antifungal susceptibility testing and whole-genome sequencing to assess isolate relatedness. RESULTS Initial PPSs at 17 facilities identified 44 additional patients with C auris in 3 (100%) LTACHs and 6 (43%) vSNFs, with the first bloodstream infection reported in May 2019. By October 2019, a total of 182 patients with C auris were identified by serial PPSs and discharge testing. Of 81 isolates that were sequenced, all were clade III and highly related. Assessments of IPC identified gaps in hand hygiene, transmission-based precautions, and environmental cleaning. The outbreak was contained to 2 facilities by October 2019. LIMITATION Acute care hospitals were not assessed, and IPC improvements over time could not be rigorously evaluated. CONCLUSION Enhanced laboratory surveillance and prompt investigation with IPC support enabled swift identification and containment of C auris. PRIMARY FUNDING SOURCE Centers for Disease Control and Prevention. |
| تدمد: | 1539-3704 0003-4819 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::0a6abf82ba3624938a2a914eab813af6 https://doi.org/10.7326/m21-2013 |
| رقم الأكسشن: | edsair.doi...........0a6abf82ba3624938a2a914eab813af6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15393704 00034819 |
|---|