PHHP 93 - Leveraging Electronic Medical Records During a Candida Auris Investigation

Background: In March 2022, the first patient with Candida auris (C. auris) infection was identified as having had a recent admission at a large tertiary care hospital. The patient had a lengthy hospitalization that included care on multiple units and had additionally had roommates during the encounter. Subsequent cases of C. auris colonization were also identified. C. auris is an emerging fungus that can spread in healthcare setting on contaminated surfaces or from person-to-person contact. Based on the size of the exposure, innovative solutions were needed to develop an efficient way to identify and follow-up with possible exposures and to rule out cases of C. auris colonization.

Methods: The electronic medical records were used to create flags for rule-out and confirmed cases of C. auris. Patients identified as a possible exposure had a rule-out flag added to charts to immediately alert staff throughout the health system to isolate and screen for C. auris. Patients were identified using a custom hospital trace report and added to a custom patient list. In-house testing was implemented that was also added an infection flag and isolation order upon test order.

Results: Of the 55 eligible patients that had been identified as possible exposures to patients with C. auris, 32 (58%) have had a readmission since the original exposure. All 32 patients were identified at the point of readmission and properly isolated and screened upon admission.

Conclusions: By leveraging the electronic medical records system to identify and track possible exposures, at-risk patients were able to be immediately isolated and screened upon readmission at any of the system healthcare facilities. The quick response led to safer care by placing the patient in appropriate isolation precautions and allowed for appropriate environmental cleaning to prevent environmental contamination of C. auris, which removed the ability of further exposures.