EP 52 - What’s Your Risk? Development of a Candida Auris Risk Factor Screening and Colonization Testing Program at an Acute Care Hospital

Background: Candida auris is a serious public health threat with increased outbreaks reported in United States hospitals and long-term care centers (LTC). Patients colonized with C. auris are asymptomatic but can still contaminate the environment and transmit C. auris to others. To prevent transmission of C. auris at our hospital, we developed a program to identify and isolate patients with risk factors for C. auris colonization using the electronic medical record (EMR). Patients who admit to the hospital with risk factors are tested for C. auris colonization.

Methods: We consulted with the Michigan Department of Health and Human Services to identify local risk factors for C. auris colonization. Three risk factors were screened: recent exposure to a LTC with (1) recent prolonged ventilation or tracheostomy or (2) history of infection with a drug-resistant organism, or (3) any patient with a recent overnight stay in a healthcare facility outside of the United States. Screening questions were built into emergency services and admitting department’s triage workflows in the EMR. Patients with risk factors were placed in contact precautions. Patients admitted to the hospital with risk factors had swabs of bilateral axillae and groin collected and tested for C. auris by real-time polymerase chain reaction (PCR). Tests resulted within 24-48 hours.

Results: The C. auris risk factor screening program was implemented in June 2022. Thirty-three patients have screened positive for C. auris risk factors. Twenty-five were tested due to hospital admission and eight patients discharged from the emergency department so testing was not collected. No tests have been positive for C. auris.

Conclusions: We sucessfully impelmented a protocol to identify C. auris in patients with risk factors for colonization. Use of the electronic medical record and triage screening faciliated identification of patients at risk and prompt isolation.