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Management of Candida auris outbreak in a tertiary-care setting in Saudi Arabia

Published online by Cambridge University Press:  03 September 2020

Majid M. Alshamrani ,
Aiman El-Saed ,
Azzam Mohammed ,
Majed F. Alghoribi ,
Sameera M. Al Johani ,
Harold Cabanalan  and
Hanan H. Balkhy
Majid M. Alshamrani*
Affiliation:
Infection Prevention and Control Department, King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Aiman El-Saed
Affiliation:
Infection Prevention and Control Department, King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Azzam Mohammed
Affiliation:
Infection Prevention and Control Department, King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia
Majed F. Alghoribi
Affiliation:
King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia King Abdullah International Medical Research Center, MNGHA, Riyadh, Saudi Arabia
Sameera M. Al Johani
Affiliation:
King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Department of Pathology Medicine, KAMC, MNGHA, Riyadh, Saudi Arabia
Harold Cabanalan
Affiliation:
Infection Prevention and Control Department, King Abdulaziz Medical City (KAMC), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia
Hanan H. Balkhy
Affiliation:
Antimicrobial Resistance, World Health Organization
*
Author for correspondence: Majid Alshamrani, E-mail: Dr_shomrani@yahoo.com
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Abstract

Objective:

To describe local experience in managing an outbreak of Candida auris in a tertiary-care setting.

Methods:

In response to emerging Candida auris, an outbreak investigation was conducted at our hospital between March 2018 and June 2019. Once a patient was confirmed to have Candida auris, screening of exposed patients and healthcare workers (HCWs) was conducted. Postexposure screening included those who had had direct contact with or shared the same unit or ward with a laboratory-confirmed case. In response to the increasing number of cases, new infection control measures were implemented.

Results:

In total, 23 primary patients were detected over 15 months. Postexposure screening identified 11 more cases, and all were patients. Furthermore, ~28.6% of patients probably caught infection in another hospital or in the community. Infection control measures were strictly implemented including hand hygiene, personal protective equipment, patient hygiene, environmental cleaning, cohorting of patients and HCWs, and avoiding the sharing of equipment. The wave reached a peak in April 2019, followed by a sharp decrease in May 2019 and complete clearance in June 2019. The case patients were equally distributed between intensive care units (51.4%) and wards (48.6%). More infections (62.9%) occurred than colonizations (37.1%). Urinary tract infection (42.9%) and candidemia (17.1%) were the main infections. In total, 7 patients (20.0%) died during hospitalization; among them, 6 (17.1%) died within 30 days of diagnosis.

Conclusions:

Active screening of exposed patients followed by strict infection control measures, including environmental cleaning, was successful in ending the outbreak. Preventing future outbreaks is challenging due to outside sources of infection and environmental resistance.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 2 , February 2021 , pp. 149 - 155
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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