| Autor: |
de St. Maurice, Annabelle, Hallmark, Amy, Hilt, Evan, Price, Travis, Uslan, Daniel, Bisht, Anjali, Yang, Shangxin, Garner, Omai |
| Zdroj: |
Infection Control & Hospital Epidemiology; October 2020, Vol. 41 Issue: Supplement 1 ps277-s278, 2p |
| Abstrakt: |
Background:Candida aurisis an emerging multidrug-resistant pathogen associated with outbreaks in hospitals and skilled nursing facilities (SNFs). Patients with C. auriscan have invasive disease or asymptomatic colonization. Because C. auriscan be difficult to treat and eradicate in the environment, the CDC recommends using contact precautions and sporicidal agents during patient care. After C. auriswas identified in a patient from an LA County SNF (SNF-X), our institution initiated surveillance screening on high-risk patients. Methods:Nurses identified patients residing at SNF-X on admission and contacted infection prevention. These patients were placed on contact or spore precautions. Bilateral axilla and inguinal folds were swabbed with an Eswab and sent for testing by a clinical laboratory-developed RT PCR assay, which can detect C. auriswith high sensitivity and specificity with a rapid turnaround time (4–6 hours). This PCR assay was based on a commercial platform IntegratedCycler (Diasorin) and reagents from the same vendor. Environmental swabs from the index patient’s room were sent for PCR by HardyCHROM Candidaagar (Hardy Diagnostics) before and after cleaning with OxyCideTM. PCR-positive samples were set up for culture. Results:In total, 27 patients from SNF-X were screened by PCR. Of these patients, 15 (55%) had a tracheostomy present on admission. Moreover, 26 swabs were negative; 1 was positive in the index patient (cycle threshold [Ct] value, 26). Clinical specimens from the index patient’s blood did not grow C. auris; the tracheostomy sample grew predominantly C. albicanswhich made identification of C. aurischallenging by culture. However, investigational testing of this sample by PCR was positive (Ct value, 31). Environmental swabs collected from the patient room were obtained before and after cleaning (Table 1); all environmental cultures were negative at 5 days. Conclusions:Developing hospital-based, high-risk patient screening for C. aurisis feasible and may be useful for controlling the spread of C. auriswithin the community. Further study is needed to determine the usefulness of PCR for environmental testing to assess the risk of nosocomial transmission of C. auris.Funding:NoneDisclosures:None |
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Supplemental Index |
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