In the July 2023 edition of Emerging Infectious Diseases, the Centers for Disease Control and Prevention (CDC) reported that they’d analyzed hospitalizations linked to the multidrug-resistant fungal pathogen Candida auris (C. auris), and found an estimated mortality rate of about one-third. They said the findings underscore the continued need for public health surveillance and C. auris containment efforts.
Using a large US hospital database, the CDC reviewed 192 C. auris‒associated hospitalizations during 2017–2022, including 38 (20%) C. auris bloodstream infections. Hospitalizations involved extensive concurrent conditions and healthcare use; estimated crude mortality rate was 34%. The hospitalizations primarily occurred among older adults (median age, 68 years) who were mostly male (54%) and non-Hispanic White patients (60%).
Underlying conditions and complications for patients with bloodstream and non-bloodstream C. auris included sepsis (64%), diabetes (55%), chronic kidney disease (44%), and pneumonia (43%). Compared with non-bloodstream C. auris, bloodstream C. auris hospitalizations more frequently involved central venous catheters (CVC) (76% vs. 53%) and tracheostomies (29% vs. 12%). Median hospitalization length was 13 days, and most hospitalizations (75.5%) involved an intensive care unit stay. The in-hospital mortality rate was 21%, and discharge locations included hospice (13%), skilled nursing facility (28%), and long-term acute care (15%). The overall estimated crude mortality rate was 34% (47% for bloodstream infections and 31% for non-bloodstream infections).
The research letter can be accessed here.
Compliance Perspective
Issue
C. auris is an emerging multidrug-resistant yeast. It can cause severe infections and spreads easily between hospitalized patients and nursing home residents. C. auris can cause bloodstream infections and even death, particularly in hospital and nursing home patients with serious medical problems. More than 1 in 3 patients with invasive C. auris infection (for example, an infection that affects the blood, heart, or brain) die. C. auris has caused outbreaks in healthcare facilities and can spread through contact with affected patients and contaminated surfaces or equipment. Good hand hygiene and cleaning in healthcare facilities is important because C. auris can live on surfaces for several weeks.
Discussion Points
- Review policies and procedures and the infection prevention and control plan to ensure they include the most effective strategies and interventions to prevent and control the spread of C. auris and other infections.
- Train staff on the most current infection prevention and control protocols, including contacting state or local public health authorities and the CDC (candidaauris@cdc.gov) immediately for guidance if a resident is suspected to have C. auris. Document that the trainings occurred and keep a signed copy in each employee’s education file.
- Periodically audit to ensure that your facility’s infection prevention and control plan contains the most current CDC guidance and is being followed by all staff members. Provide additional education as needed.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
