Candida auris outbreak in a cardiothoracic transplant intensive care unit: implications for infection prevention practices and keeping pace with an evolving landscape.

IF 3 4区 医学 Q2 INFECTIOUS DISEASES
Shardul N Rathod, Grace Barajas, Brooks I Mitchell, Michael Malczynski, W Justin Moore, Erin Weslander, Christine Bulger, Andrea Stone, Abbas Al-Qamari, Christie M Bertram, Sarah H Sutton, Valentina Stosor, Chao Qi, Teresa R Zembower, Maureen K Bolon
{"title":"<i>Candida auris</i> outbreak in a cardiothoracic transplant intensive care unit: implications for infection prevention practices and keeping pace with an evolving landscape.","authors":"Shardul N Rathod, Grace Barajas, Brooks I Mitchell, Michael Malczynski, W Justin Moore, Erin Weslander, Christine Bulger, Andrea Stone, Abbas Al-Qamari, Christie M Bertram, Sarah H Sutton, Valentina Stosor, Chao Qi, Teresa R Zembower, Maureen K Bolon","doi":"10.1017/ice.2025.10217","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To describe the mitigation strategies for a <i>Candida auris</i> outbreak in a cardiothoracic transplant intensive care unit (CTICU) and its implications for infection prevention practices.</p><p><strong>Design: </strong>Retrospective cohort study from July 2023 to February 2024.</p><p><strong>Setting: </strong>A large academic medical center.</p><p><strong>Methods: </strong>A multidisciplinary team convened to conduct the outbreak investigation and develop mitigation strategies in the CTICU.</p><p><strong>Results: </strong>From July 2023 to February 2024, 34 possible hospital-onset cases of <i>C. auris</i> were identified in our CTICU. Whole-genome sequencing and phylogenetic analysis based on pairwise single nucleotide polymorphism (WG-SNP) distance revealed two distinct outbreak clusters. Of the 34 patients, 11 (32.3%) were solid organ transplant recipients and 12 (35.3%) had a mechanical circulatory support device. Of the cohort, only 11/34 (32.3%) had prior exposure to high-risk healthcare facilities within six months prior to admission, as follows: acute inpatient rehabilitation facilities (AIRs) (n = 5, 14.7%), skilled nursing facilities (SNFs) (n = 3, 8.8%), and long-term acute care hospitals (LTACHs) (n = 3, 8.8%). The cohort had a median of 22.0 antibiotic-days prior to their positive results. Five (14.7%) patients had <i>C. auris</i> candidemia, three of whom expired likely due to infection. Infection Prevention (IP) interventions addressed several modes of transmission, including healthcare personnel hands, shared patient equipment, and the environment.</p><p><strong>Conclusion: </strong>Our experience suggests that the epidemiology of <i>C. auris</i> may be changing, pointing towards a rising prevalence in acute care settings. IP interventions targeting hand hygiene behavior and promoting centralizing cleaning and disinfection of shared patient equipment may have contributed to outbreak resolution.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Control and Hospital Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/ice.2025.10217","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To describe the mitigation strategies for a Candida auris outbreak in a cardiothoracic transplant intensive care unit (CTICU) and its implications for infection prevention practices.

Design: Retrospective cohort study from July 2023 to February 2024.

Setting: A large academic medical center.

Methods: A multidisciplinary team convened to conduct the outbreak investigation and develop mitigation strategies in the CTICU.

Results: From July 2023 to February 2024, 34 possible hospital-onset cases of C. auris were identified in our CTICU. Whole-genome sequencing and phylogenetic analysis based on pairwise single nucleotide polymorphism (WG-SNP) distance revealed two distinct outbreak clusters. Of the 34 patients, 11 (32.3%) were solid organ transplant recipients and 12 (35.3%) had a mechanical circulatory support device. Of the cohort, only 11/34 (32.3%) had prior exposure to high-risk healthcare facilities within six months prior to admission, as follows: acute inpatient rehabilitation facilities (AIRs) (n = 5, 14.7%), skilled nursing facilities (SNFs) (n = 3, 8.8%), and long-term acute care hospitals (LTACHs) (n = 3, 8.8%). The cohort had a median of 22.0 antibiotic-days prior to their positive results. Five (14.7%) patients had C. auris candidemia, three of whom expired likely due to infection. Infection Prevention (IP) interventions addressed several modes of transmission, including healthcare personnel hands, shared patient equipment, and the environment.

Conclusion: Our experience suggests that the epidemiology of C. auris may be changing, pointing towards a rising prevalence in acute care settings. IP interventions targeting hand hygiene behavior and promoting centralizing cleaning and disinfection of shared patient equipment may have contributed to outbreak resolution.

心胸移植重症监护病房的耳念珠菌暴发:对感染预防实践的影响并与不断变化的环境保持同步。
目的:描述在心胸移植重症监护病房(CTICU)爆发耳念珠菌的缓解策略及其对感染预防实践的影响。设计:回顾性队列研究,时间为2023年7月至2024年2月。环境:大型学术医疗中心。方法:召集一个多学科小组在CTICU开展疫情调查并制定缓解策略。结果:2023年7月至2024年2月,我院CTICU共发现34例可能住院的C. auris病例。全基因组测序和基于成对单核苷酸多态性(WG-SNP)距离的系统发育分析显示了两个不同的爆发集群。34例患者中,11例(32.3%)接受实体器官移植,12例(35.3%)使用机械循环支持装置。在该队列中,只有11/34(32.3%)在入院前6个月内曾暴露于高风险医疗机构,包括:急性住院康复机构(air) (n = 5, 14.7%)、熟练护理机构(SNFs) (n = 3, 8.8%)和长期急性护理医院(LTACHs) (n = 3, 8.8%)。该队列在阳性结果前的中位数为22.0抗生素天。5例(14.7%)患者有耳念珠菌,其中3例可能因感染而死亡。感染预防(IP)干预措施涉及几种传播模式,包括医护人员的手、共用的患者设备和环境。结论:我们的经验表明,金黄色葡萄球菌的流行病学可能正在发生变化,在急性护理环境中患病率上升。以手卫生行为为目标的知识产权干预措施和促进对共用患者设备的集中清洁和消毒可能有助于疫情的解决。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.40
自引率
6.70%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信