Candida auris admission screening pilot in select units of New York City health care facilities, 2017-2019

Abstract

Background: This pilot project implemented admission screening for Candida auris (C. auris) using real-time polymerase chain reaction (rt-PCR) in select high-risk units within health care facilities in New York City.

Methods: An admission screening encounter consisted of collecting 2 swabs, to be tested by rt-PCR, and a data collection form for individuals admitted to ventilator units at 2 nursing homes (NHA and NHB), and the ventilator/pulmonary unit, intensive care unit, and cardiac care unit at a hospital (Hospital C) located in New York City from November 2017 to November 2019.

Results: C. auris colonization was identified in 6.9% (n = 188/2,726) of admissions to participating units. Rates were higher among admissions to NHA and NHB (20.7% and 22.0%, respectively) than Hospital C (3.6%). Within Hospital C, the ventilator/pulmonary unit had a higher rate (5.7%) than the intensive care unit (3.8%) or cardiac care unit (2.5%).

Discussion: Consistent with prior research, we found that individuals admitted to ventilator units were at higher risk of C. auris colonization.

Conclusions: This project demonstrates the utility of admission screening using rt-PCR testing to rapidly identify C. auris colonization among admissions to health care facilities so that appropriate transmission-based precautions and control measures can be implemented rapidly to help decrease transmission.

Keywords: Candida auris admission screening health care facility; Colonization; Fungal; Multidrug Resistance.

Fig 1.

Proportion of Hospital C admissions who screened rt-PCR positive for C. auris by prior location. *All individuals who tested positive admitted from a private residence had an admission to a HCF in the 90 days prior. rt-PCR, real-time polymerase chain reaction; C. auris, Candida auris.