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healthcare-associated Infections (HAI) program

Candida auris ​​ (C. auris)

ABOUT

Candida auris (C.auris) is an emerging multi-drug resistant yeast that can spread in healthcare settings via person-to-person transmission or contact with contaminated surfaces. C. auris causes serious, hard to treat infections in hospitalized patients. CDC provides the most recent case counts for each state on their Tracking Candida website.

INFECTION CONTROL AND PREVENTION

Public health departments and healthcare providers can work together to prevent the emergence and transmission of C. auris. Rigorous adherence to infection control practices can prevent the spread of C. auris.

 

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​HEALTHCARE PROVIDERS

​PUBLIC HEALTH PARTNERS

​Laboratory Identification

​Surveillance

  • ​Perform species identification on all yeast from invasive sources
  • Ensure the laboratory notifies infection prevention immediately following a positive result for C. auris, even if preliminary. Early detection of C. auris is essential for containing its spread in healthcare facilities
  • ​Know the local epidemiology and prevalence in your region.
  • Understand patient risk factors and high risk settings, such as indwelling medical devices in patients residing in high acuity long-term care facilities

​Colonization Testing

  • ​When a patient with C. auris is identified, implement screening of high-risk patients and patient contacts for C. auris colonization. Patients colonized with C. auris may not need medical treatment but can be potential sources of transmission to others
    • High risk patient contacts include roommates and other patients residing in the same unit.
    • Other high risk patients to consider for C. auris colonization testing include:
      • Those who have extensive exposure to healthcare facilities, especially long-term care facilities with ventilator units
      • Those who are colonized with another multi-drug resistant organism, especially carbapenemase-producing organisms 
      • Those who have indwelling medical devices
      • Those who have recently received healthcare outside countries where C. auris transmission has been reported

  • Colonization testing services can be accessed free of charge using the CDC Antibiotic Resistance Laboratory Network (ARLN). Please contact your local health department when considering C. auris colonization testing

  • ​Colonization testing services can be accessed using the CDC Antibiotic Resistance Laboratory Network (ARLN) Please contact the HAI Program for assistance coordinating C. auris colonization testing

​Infection Control Measures

  • ​Understand and recommend infection control measures for patients colonized or infected with C. auris, including Standard and Contact Precautions
  • Be prepared to conduct a site visit when necessary and assess implementation of infection control strategies. Contact the HAI Program for more information on performing infection control assessments
  • Tools for monitoring adherence to infection control measures are available on the CDPH HAI Program website

​Environmental Cleaning

  • ​Ensure and audit thorough daily and terminal environment cleaning of patient care environment and reusable equipment
    • Focus on high-touch surfaces or any shared reusable patient equipment
    • CDC recommends use of an EPA registered hospital-grade disinfectant effective against Clostridioides difficile spores (List K)
    • Daily and terminal cleaning of patient environment using a List K product may be extended to an entire unit or facility where patients with C. auris are located 

  • Review environmental cleaning checklists that are available on the CDPH HAI Program website

​Adherence Monitoring

  • ​Use adherence monitoring tools to assess and track provider adherence to infection control measures. Monitoring adherence and providing feedback to staff are critical to sustained implementation of infection prevention measures
  • ​During  an outbreak, request documentation of adherence monitoring results from affected facility/facilities

​Interfacility Communication

  • ​Communicate C. auris status to the receiving facility ahead of time to ensure appropriate care is maintained when transferring a patient/resident

  • Use the HAI Program interfacility transfer form during all patient transfers available via the Interfacility Transfer Communications Guide page. 

  • ​Set expectations for facilities to effectively communicate C. auris status when transferring patients/residents to another healthcare facility
  • During an outbreak, consider requesting facilities notify public health of all discharges and transfers involving individuals with C. auris

​Antimicrobial Stewardship

​Regional Prevention

​Reporting

​Treatment

  • ​Consultation with an infectious disease specialist is highly recommended for patients infected with C. auris. See CDC’s guidance for more detailed treatment information

  • ​Antifungal susceptibility testing helps identify effective treatment options. Contact the HAI Program to coordinate submission of C. auris isolates to CDC for antifungal susceptibility testing

 

ADDITIONAL C. auris RESOURCES

For additional information, contact the HAI Program at HAIProgram@cdph.ca.gov.

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