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. 2019 Oct 28;4(2):260-270.
doi: 10.20411/pai.v4i2.291. eCollection 2019.

Environmental Contamination with Candida Species in Multiple Hospitals Including a Tertiary Care Hospital with a Candida auris Outbreak

Jessica Kumar  1 , Brandon Eilertson  2 , Jennifer L Cadnum  3 , Chauna S Whitlow  4 , Annette L Jencson  3 , Nasia Safdar  5   6 , Sarah L Krein  7 , Windy D Tanner  8 , JeanMarie Mayer  8 , Matthew H Samore  8 , Curtis J Donskey  1   9
Affiliations

Environmental Contamination with Candida Species in Multiple Hospitals Including a Tertiary Care Hospital with a Candida auris Outbreak

Jessica Kumar et al. Pathog Immun. .

Abstract

Background: Environmental sources have been implicated as a potential source for exogenous acquisition of Candida species, particularly the emerging multidrug-resistant Candida auris. However, limited information is available on environmental reservoirs of Candida species in healthcare facilities.

Methods: During a 6-month period, cultures for Candida species were collected from high-touch surfaces in patient rooms and from portable equipment in 6 US acute care hospitals in 4 states. Additional cultures were collected from sink drains and floors in one of the hospitals and from high-touch surfaces, portable equipment, and sink drains in a hospital experiencing an outbreak due to C. auris. Candida species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectometry.

Results: Candida species were recovered from patient rooms in 4 of the 6 hospitals. Seven of 147 patient room cultures (4.8%) and 1 of 57 (1.8%) portable equipment cultures were positive, with the most common species being C. parapsilosis. For the hospital where additional sites were sampled, Candida species were recovered from 8 of 22 (36.4%) hospital room floors and 4 of 17 (23.5%) sink drains. In the facility with a C. auris outbreak, Candida species were frequently recovered from sink drains (20.7%) and high-touch surfaces (15.4%), but recovery of C. auris was uncommon (3.8% of high-touch surfaces, 3.4% of sink drains, and 0% of portable equipment) and only present in rooms that currently or recently housed a patient with C. auris.

Conclusion: Candida species often contaminate surfaces in hospitals and may be particularly common on floors and in sink drains. However, C. auris contamination was uncommon in a facility experiencing an outbreak, suggesting that current cleaning and disinfection practices can be effective in minimizing environmental contamination.

Keywords: Candida auris; Candida species; environmental contamination; floor and sink drain disinfection; infection control.

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Conflict of interest statement

Curtis J. Donskey has received research grants from Pfizer, GOJO, Clorox, PDI, and Boehringer Laboratories. He is also an associate editor for Pathogens and Immunity. All other authors report no conflicts of interest relevant to this article.

Figures

Figure 1.
Figure 1.
Frequency of recovery of Candida species from environmental surfaces in patient rooms in 6 hospitals.
See this image and copyright information in PMC

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