Candida auris in Dutch hospitals: are we ready for it?

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-02-01 DOI:10.1016/j.jhin.2024.12.004

L.M.L. Dix , D.W. Notermans , C. Schneeberger , K. van Dijk

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引用次数: 0

Abstract

Background

Candida auris can cause nosocomial outbreaks and provides challenges concerning diagnosis, treatment, eradication and infection prevention. There are no Dutch standards or guidelines for C. auris, and current hospital practices are unknown. Therefore, we assessed whether Dutch hospitals are prepared for C. auris introduction.

Methods

An online questionnaire concerning screening, diagnostics, infection prevention and outbreaks was distributed amongst medical microbiologists and infection prevention practitioners in spring 2024.

Findings

Fifty-two questionnaires were processed comprising 58 hospitals. Most participants (60%) did not screen for C. auris carriership and 51% did not have a protocol describing screening procedures. Healthcare workers were rarely screened. Screening sites and number of swabs varied. All respondents would place a patient with C. auris in isolation, 71% had a protocol describing isolation measures. Most hospitals took extra cleaning precautions after finding C. auris. None of the hospitals ever had a C. auris-outbreak, 29% had an outbreak protocol. Procedures to cease isolation were present in 31%, but 10% never declare a patient C. auris-free. A diagnostic protocol (available in 53%) was primarily based on culture, but the execution differed. Molecular diagnostics were rarely used (12%). The majority did not screen nor did they have a protocol describing multi-drug-resistant candida outbreak coordination.

Conclusions

Screening, diagnostics, infection prevention, control and outbreak management of C. auris vary amongst Dutch hospitals, and most are not fully prepared for C. auris. As inadequate preparation for C. auris is an international concern, guidance documents could aid in fulfilling this need.

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荷兰医院中的耳念珠菌：我们准备好了吗？

背景：耳念珠菌可引起院内暴发，对诊断、治疗、根除和预防感染提出了挑战。荷兰没有针对金黄色葡萄球菌的标准或指导方针，目前医院的做法也不得而知。因此，我们评估了荷兰医院是否为引入C. auris做好了准备。方法：于2024年春季向医学微生物学家和感染预防从业人员发放关于筛查、诊断、感染预防和暴发的在线问卷。结果：共处理问卷52份，涉及58家医院。大多数参与者（60%）没有筛查金黄色葡萄球菌携带者，51%的参与者没有描述筛查程序的方案。卫生保健工作者很少接受筛查。筛查地点和拭子数量各不相同。所有应答者都会将患有金黄色葡萄球菌的患者隔离，71%的应答者有描述隔离措施的方案。大多数医院在发现金黄色葡萄球菌后都采取了额外的清洁措施。没有一家医院爆发过金黄色葡萄球菌，29%的医院有爆发协议。31%的国家有停止隔离的程序，但10%的国家从未宣布患者无耳c菌。诊断方案（53%）主要基于培养，但执行方法不同。很少使用分子诊断（12%）。大多数没有筛查，也没有描述耐多药念珠菌爆发协调的方案。结论：荷兰各医院对金黄色葡萄球菌的筛查、诊断、感染预防、控制和疫情管理各不相同，大多数医院没有为金黄色葡萄球菌做好充分准备。由于对金黄色葡萄球菌的准备不足是一个国际问题，指导文件可以帮助满足这一需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.