Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 1;72(11):e753-e760.
doi: 10.1093/cid/ciaa1462.

Factors Associated With Candida auris Colonization and Transmission in Skilled Nursing Facilities With Ventilator Units, New York, 2016-2018

John Rossow  1   2 , Belinda Ostrowsky  3 , Eleanor Adams  4 , Jane Greenko  4 , Robert McDonald  1   5 , Snigdha Vallabhaneni  2   3 , Kaitlin Forsberg  2 , Stephen Perez  1 , Todd Lucas  1 , Karen A Alroy  1 , Kara Jacobs Slifka  3 , Maroya Walters  3 , Brendan R Jackson  2 , Monica Quinn  5 , Sudha Chaturvedi  6   7 , Debra Blog  5   7 ; New York Candida auris Investigation Workgroup
Collaborators, Affiliations

Factors Associated With Candida auris Colonization and Transmission in Skilled Nursing Facilities With Ventilator Units, New York, 2016-2018

John Rossow et al. Clin Infect Dis. .

Abstract

Background: Candida auris is an emerging, multidrug-resistant yeast that spreads in healthcare settings. People colonized with C. auris can transmit this pathogen and are at risk for invasive infections. New York State (NYS) has the largest US burden (>500 colonized and infected people); many colonized individuals are mechanically ventilated or have tracheostomy, and are residents of ventilator-capable skilled nursing facilities (vSNF). We evaluated the factors associated with C. auris colonization among vSNF residents to inform prevention interventions.

Methods: During 2016-2018, the NYS Department of Health conducted point prevalence surveys (PPS) to detect C. auris colonization among residents of vSNFs. In a case-control investigation, we defined a case as C. auris colonization in a resident, and identified up to 4 residents with negative swabs during the same PPS as controls. We abstracted data from medical records on patient facility transfers, antimicrobial use, and medical history.

Results: We included 60 cases and 218 controls identified from 6 vSNFs. After controlling for potential confounders, the following characteristics were associated with C. auris colonization: being on a ventilator (adjusted odds ratio [aOR], 5.9; 95% confidence interval [CI], 2.3-15.4), receiving carbapenem antibiotics in the prior 90 days (aOR, 3.5; 95% CI, 1.6-7.6), having ≥1 acute care hospital visit in the prior 6 months (aOR, 4.2; 95% CI, 1.9-9.6), and receiving systemic fluconazole in the prior 90 days (aOR, 6.0; 95% CI, 1.6-22.6).

Conclusions: Targeted screening of patients in vSNFs with the above risk factors for C. auris can help identify colonized patients and facilitate the implementation of infection control measures. Antimicrobial stewardship may be an important factor in the prevention of C. auris colonization.

Keywords: Candida auris; colonization; mechanical ventilation; multidrug-resistant organisms; skilled nursing facilities.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Facility maps depicting the Candida auris colonization status and location of patients at the time of a single point prevalence survey in the ventilator unit of a skilled nursing facility, New York, 2016–2018.
See this image and copyright information in PMC

References

    1. Chowdhary A, Sharma C, Meis JF. Candida auris: a rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally. PLoS Pathog 2017; 13:e1006290. - PMC - PubMed
    1. Satoh K, Makimura K, Hasumi Y, Nishiyama Y, Uchida K, Yamaguchi H. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol Immunol 2009; 53:41–4. - PubMed
    1. Lone SA, Ahmad A. Candida auris—the growing menace to global health. Mycoses 0. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1111/myc.12904. Accessed 17 April 2019. - DOI - PubMed
    1. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2019. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, 2019. Available at: www.cdc.gov/DrugResistance/Biggest-Threats.html. Accessed 19 November 2019.
    1. Bergeron G, Bloch D, Murray K, et al. Candida auris colonization in the community setting-New York City (NYC), 2017—2018. In: 2019. CSTE Annual Conference. Raleigh, North Carolina. 2019. Available at: https://cste.confex.com/cste/2019/meetingapp.cgi/Paper/11146. Accessed 22 June 2020.

Publication types