scholarly journals First Candida auris Outbreak Experience in a Tertiary-Care General Hospital in Qatar, 2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s235-s236
Author(s):  
Feah Visan ◽  
Naser Al Ansari ◽  
Walid Al Wali ◽  
Almunzer Zakaria ◽  
Omar Al Hasanat ◽  
...  
Keyword(s):  
General Hospital ◽  
Index Case ◽  
Scientific Evidence ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Inpatient Unit ◽  
Candida Auris ◽  
Medical Inpatient ◽  
First Case ◽  
Screening Protocol

Background:Candida auris is an invasive, multidrug-resistant pathogen that can cause outbreaks in hospitals. The mode of transmission is through contaminated hospital items such as fomites and staff interventions. The outbreak of Candida auris affecting 13 patients at the medical intensive care unit (MICU) and medical inpatient unit, either in the form of infection or colonization, is the first documented C. auris outbreak in the Qatar. Methods: The first case was identified in November 2018 in a patient colonized in the respiratory tract. Candida auris biweekly tests were conducted. The second to fourth cases were confirmed in the MICU admitted in the same room (room 2). The fifth case was identified incidentally and was not part of the screening in another ward (6 North Medical Inpatient Unit), and 4 weeks later, Candida auris was isolated from the urine and throat of a patient on this ward. The realization that case 5 was an index case changed the direction of the outbreak investigation, and expanded screening was started among the medical inpatients. When the IPC team identified cases 6–11 and 13, all had possible epidemiological links with case 5. Results: Our root-cause analysis suggests that the index case came from another general hospital. However, because no screening protocol has been established for Candida auris, interventions have not been in place to effectively prevent and control this organism. A strong collaborative outbreak team worked to end this outbreak using the following evidence-based IPC interventions: (1) patient screening and decolonization; (2) environmental screening; (3) enhanced environmental disinfection using peracetic acid wipes, 1% chlorine, and hydrogen peroxide vapor disinfection; (4) prophylactic contact precautions; (5) enhanced hand hygiene with bare below elbows protocol; and (6) a no white gown policy. Conclusions: The outbreak of Candida auris was declared to have nbeen terminated on August 22, 2019. Despite the long period involved in this outbreak, we succeeded in ending it through the concerted efforts of a multidisciplinary team utilizing the latest scientific evidence.Funding: NoneDisclosures: None

scholarly journals Candida auris emergence in the Himalayan foothills: First case report from Uttarakhand, India

2020 ◽  
Author(s):  
Suneeta Meena ◽  
Ranjana Rohilla ◽  
Neelam Kaistha ◽  
Arpana Singh ◽  
Pratima Gupta
Keyword(s):  
Case Report ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Whipple Procedure ◽  
Care Hospital ◽  
Candida Auris ◽  
Flight Mass Spectrometry ◽  
First Case ◽  
The Matrix ◽  
Head Of The Pancreas

Background and Purpose: Candida auris is a rapidly emerging fungus, which is considered globally a cause of concern for public health. This report describes the first case of C. auris fungemia from a tertiary care hospital in the hilly state of Uttarakhand in India. Case report: The patient was a 37-year-old female who underwent a Whipple procedure for the carcinoma of the head of the pancreas. She developed fever 12 days after the operation while recovering from surgery in the hospital. Blood culture yielded C. auris which was identified by the matrix-assisted laser desorption/ionization-time of flight mass spectrometry (Bruker Daltonics, Germany). The patient was successfully treated with caspofungin. Conclusion: In conclusion, C. auris is potentially multidrug resistant, resulting in nosocomial outbreaks and sporadic infections which can be potentially prevented when identified early by implementing contact precautionsBackground and Purpose: Candida auris is a rapidly emerging fungus, which is considered globally a cause of concern for public health. This report describes the first case of C. auris fungemia from a tertiary care hospital in the hilly state of Uttarakhand in India. Case report: The patient was a 37-year-old female who underwent a Whipple procedure for the carcinoma of the head of the pancreas. She developed fever 12 days after the operation while recovering from surgery in the hospital. Blood culture yielded C. auris which was identified by the matrix-assisted laser desorption/ionization-time of flight mass spectrometry (Bruker Daltonics, Germany). The patient was successfully treated with caspofungin. Conclusion: In conclusion, C. auris is potentially multidrug resistant, resulting in nosocomial outbreaks and sporadic infections which can be potentially prevented when identified early by implementing contact precautions.

scholarly journals Evaluation of psychotropic prescription patterns at the time of discharge from inpatient unit of a tertiary care general hospital psychiatric unit

2016 ◽  
Vol 21 (1) ◽  
pp. 48 ◽  
Author(s):  
Sandeep Grover ◽  
Naresh Nebhinani ◽  
Subho Chakrabarti ◽  
Ajit Avasthi ◽  
SurendraKumar Mattoo ◽  
...  
Keyword(s):  
General Hospital ◽  
Tertiary Care ◽  
Inpatient Unit ◽  
Psychiatric Unit ◽  
Prescription Patterns

scholarly journals Environmental Contamination with Candida Species in Multiple Hospitals Including a Tertiary Care Hospital with a Candida auris Outbreak

2019 ◽  
Vol 4 (2) ◽  
pp. 260 ◽  
Author(s):  
Jessica Ann Kumar ◽  
Brandon Eilertson ◽  
Jennifer L. Cadnum ◽  
Chauna S. Whitlow ◽  
Annette L. Jencson ◽  
...  
Keyword(s):  
Environmental Contamination ◽  
Candida Species ◽  
Tertiary Care ◽  
Common Species ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Limited Information ◽  
Portable Equipment ◽  
Candida Auris ◽  
Cleaning And Disinfection

Background: Environmental sources have been implicated as a potential source for exogenous acquisition of Candida species, particularly the emerging multidrug-resistant Candida auris. However, limited information is available on environmental reservoirs of Candida species in healthcare facilities.Methods: During a 6-month period, cultures for Candida species were collected from high-touch surfaces in patient rooms and from portable equipment in 6 US acute care hospitals in 4 states. Additional cultures were collected from sink drains and floors in one of the hospitals and from high-touch surfaces, portable equipment, and sink drains in a hospital experiencing an outbreak due to C. auris. Candida species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectometry.Results: Candida species were recovered from patient rooms in 4 of the 6 hospitals. Seven of 147 patient room cultures (4.8%) and 1 of 57 (1.8%) portable equipment cultures were positive, with the most common species being C. parapsilosis. For the hospital where additional sites were sampled, Candida species were recovered from 8 of 22 (36.4%) hospital room floors and 4 of 17 (23.5%) sink drains. In the facility with a C. auris outbreak, Candida species were frequently recovered from sink drains (20.7%) and high-touch surfaces (15.4%), but recovery of C. auris was uncommon (3.8% of high-touch surfaces, 3.4% of sink drains, and 0% of portable equipment) and only present in rooms that currently or recently housed a patient with C. auris.Conclusion: Candida species often contaminate surfaces in hospitals and may be particularly common on floors and in sink drains. However, C. auris contamination was uncommon in a facility experiencing an outbreak, suggesting that current cleaning and disinfection practices can be effective in minimizing environmental contamination.

scholarly journals First Case of Candida auris Colonization in a Preterm, Extremely Low-Birth-Weight Newborn after Vaginal Delivery

2021 ◽  
Vol 7 (8) ◽  
pp. 649
Author(s):  
Alessio Mesini ◽  
Carolina Saffioti ◽  
Marcello Mariani ◽  
Angelo Florio ◽  
Chiara Medici ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Vaginal Delivery ◽  
Multidrug Resistant ◽  
Antifungal Prophylaxis ◽  
Extremely Low Birth Weight ◽  
Preterm Neonates ◽  
Candida Auris ◽  
First Case

Candida auris is a multidrug-resistant, difficult-to-eradicate pathogen that can colonize patients and health-care environments and cause severe infections and nosocomial outbreaks, especially in intensive care units. We observed an extremely low-birth-weight (800 g), preterm neonate born from vaginal delivery from a C. auris colonized mother, who was colonized by C. auris within a few hours after birth. We could not discriminate whether the colonization route was the birth canal or the intensive care unit environment. The infant died on her third day of life because of complications related to prematurity, without signs or symptoms of infections. In contexts with high rates of C.auris colonization, antifungal prophylaxis in low-birth-weight, preterm neonates with micafungin should be considered over fluconazole due to the C. auris resistance profile, at least until its presence is excluded.

scholarly journals Outbreak investigation of Candida auris at a tertiary care hospital in Karachi, Pakistan

2020 ◽  
Vol 21 (5) ◽  
pp. 189-195
Author(s):  
Joveria Q Farooqi ◽  
Asad S Soomro ◽  
Mirza A Baig ◽  
Shamoona F Sajjad ◽  
Kamran Hamid ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Fatality ◽  
Multidrug Resistant ◽  
Outbreak Investigation ◽  
Care Hospital ◽  
Candida Auris ◽  
Control And Prevention ◽  
History Of ◽  
Age Range

Background: From September 2014, a tertiary care hospital in Karachi, Pakistan, started diagnosing 3–5 cases/month of a yeast locally identified as Saccharomyces spp. resistant to fluconazole. US Centers for Disease Control and Prevention identified the isolates as Candida auris. The Pakistan Field Epidemiology and Laboratory Training Program (FELTP) and the hospital investigated the outbreak from April 2015 to January 2016. Objective: The aim of the outbreak investigation was to determine the risk factors and to inform measures to limit the spread of the organism in the hospital. Methods: Medical records, nursing schedules and infection control practices were reviewed. Sixty-two age- and sex-matched hospital controls from the same wards were identified. Results: Thirty cases (17 males) were identified (mean age = 51.6 years, age range = 2–91 years), case fatality was 53%. Multivariate logistic regression showed that a history of surgery within 90 days of diagnosis, admission to the emergency department and history of chronic kidney disease were significantly associated with C. auris infection. Discussion: This is the report of the outbreak investigation that triggered a global exploration of C. auris as a newly identified multidrug-resistant nosocomial organism, spreading within the hospital, especially among patients with invasive procedures. Unfortunately, we could not identify any specific source of the outbreak nor stop the transmission of the organism.

Multidrug-Resistant Candida auris Fungemia in Critical Care Units: Experience from a Tertiary Care Hospital in India

2020 ◽  
Vol 26 (2) ◽  
pp. 145-149
Author(s):  
Vijeta Bajpai ◽  
Aishwarya Govindaswamy ◽  
Sushma Sagar ◽  
Subodh Kumar ◽  
Pramod Garg ◽  
...  
Keyword(s):  
Critical Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Candida Auris ◽  
Critical Care Units

scholarly journals KNOW Candida auris: Prevention of another outbreak through screening and early identification

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Zubaria Altaf ◽  
Omar Al Hasanat ◽  
Jenalyn Castro ◽  
Ubaid Ummer ◽  
Mohamed Safwat Gomaa Amr ◽  
...  
Keyword(s):  
Early Identification ◽  
Screening Program ◽  
Preventive Measure ◽  
Cost Effective ◽  
Multidrug Resistant ◽  
Public Healthcare ◽  
Candida Auris ◽  
Safe Patient Care ◽  
Contact Precautions ◽  
Screening Protocol

Background: Candida auris, within the last decade, has emerged as a multidrug resistant public health threat that can lead to hospital outbreaks. It is an invasive fungal yeast resistant to multiple antifungal agents. The mode of transmission is through contaminated hospital items (including clothes and furniture) and interventions by staff. Two Candida auris outbreaks occurred in Qatar. The first outbreak was in Al Wakra Hospital (AWH), which is a facility of Hamad Medical Corporation (HMC), the principal public healthcare provider in the State of Qatar. As concluded by Eyre DW, et al. (2018), a series of interventions and environmental screening program may reduce the Candida auris outbreak. A screening toolkit that includes a checklist based on an existing protocol and operationally defined criteria is a key preventive measure for Candida auris identification. We aim to attain 100% compliance with screening suspected patients and preventing further outbreaks. Methods: A screening protocol toolkit was created for eligible patients that allowed early identification and prompt intervention therefore enhancing the provision of high-quality, efficient, cost effective, and safe patient care. Furthermore, implementation of an Outbreak Prevention Bundle had been proven effective in preventing the spread and comprised: (1) prophylactic contact precautions, (2) blanket screening of at risk/exposed patients, (3) environmental sampling, and (4) hydrogen peroxide disinfection. Results/Findings/Recommendations: In 2020, continuous screening was maintained for patients fitting the HMC criteria. The protocol for the management of outbreaks was implemented. The number of COVID-19 positive cases peaked during July - August 2020 when COVID-19 patients were transferred to AWH . Overall, AWH reached 407 cumulative days without Candida auris outbreak . Conclusion: Candida auris outbreak is preventable through early identification via screening and implementation of an Outbreak Prevention Bundle. This method has led to no active outbreak in AWH since August 2019 until October 2020.

scholarly journals 266. Clinical Profile and Treatment Outcomes of Candida auris Isolates from a Tertiary Care Hospital in South India

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S147-S148
Author(s):  
Anup R Warrier ◽  
Arun Wilson ◽  
Rachana Babu ◽  
Shilpa Prakash ◽  
Madhav Bhargava
Keyword(s):  
Treatment Outcomes ◽  
Tertiary Care ◽  
Case Series ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Wound Management ◽  
Care Hospital ◽  
Candida Auris ◽  
Sensitivity Pattern ◽  
Anti Fungal

Abstract Background Candida auris is an emerging multidrug-resistant fungus that is rapidly spreading worldwide. In publications from India, it has already accounted for >5% of candidemia in a national survey of ICUs and as much as 30% of candidemia at individual hospitals,but data on treatment outcomes is scarce. This study reviews the various clinical syndromes in our case series, the treatment regimens we opted and their clinical outcomes. Methods The present study was a retrospective observational analysis of candida auris isolates obtained from patients admitted in a Aster Medcity, Kochi. Duration of study was 4 months (September 2018 to December 2018). Laboratory confirmation of the candida auris isolates was done as per CDC recommendations for Vitek2. Vitek2 was also used for obtaining the antifungal sensitivity pattern for these isolates. Results We had 18 cases of Candida auris identified. The most common syndrome was surgical site infections, 9 out of 18 (50%), followed by Catheter-Associated Urinary Tract Infection (CAUTI 5/18; 28%). We had 3 patients with Central Line-Associated Blood Stream Infections (CLABSI) and one patient who had secondary peritonitis. The overall mortality was 28% (5/18)—mostly contributed by the CLABSI. Considering breakpoints from CLSI as well as CDC, all isolates had their minimum inhibitory concentration (MIC) in the sensitive range for Caspofungin. Both Amphotericin b and Voriconazole had MICs in susceptible range for less than 50% of the isolates and almost all isolates were having very high MICs for Fluconazole, highlighting the increased levels of antifungal resistance which has made this Candida species notorious. Conclusion Candida auris is an emerging nosocomial pathogen in India with serious outbreak potential. The anti-fungal susceptibility is indicative of a multidrug-resistant pattern—with favorable MIC to Echinocandin and Voriconazole. Complicated bloodstream infections had high mortality inspite of early Echinocandin use. Of note, 6 patients out of 18, were managed successfully without any anti-fungal use; as they had either mild UTI (fever spikes resolved with catheter removal) or superfical SSI which could be treated with topical wound management. Disclosures All authors: No reported disclosures.

Prevalence, epidemiology and clinical outcome of Candida auris infections: Experience from a tertiary care hospital in Jaipur

2021 ◽  
pp. 004947552110286
Author(s):  
Daisy Bacchani ◽  
Ekadashi Rajni ◽  
Vishnu K Garg ◽  
Richa Sharma ◽  
Ved P Mamoria
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Emerging Pathogen ◽  
Broad Spectrum Antibiotic ◽  
Candida Auris ◽  
History Of ◽  
Echinocandin Resistance ◽  
Healthcare Associated

Candida auris is identified as an emerging pathogen worldwide. It is multidrug resistant and causes invasive healthcare-associated infections. Our retrospective study was conducted to determine the prevalence and epidemiology of C. auris infections in a tertiary care hospital in Jaipur. 24 clinical C. auris strains were included, most being from urine. The majority patients needed intensive care and had at least one underlying co-morbid condition. A history of broad-spectrum antibiotic or antifungal usage was present in 85%. Fluconazole, voriconazole, amphotericin B and 5-fluorocytosine resistance was seen in 96, 42, 33 and 8% isolates respectively. No echinocandin resistance was noted.

scholarly journals Retrospective Analysis of the Clinical Characteristics of Candida auris Infection Worldwide From 2009 to 2020

2021 ◽  
Vol 12 ◽  
Author(s):  
Shan Hu ◽  
Feilong Zhu ◽  
Weiwei Jiang ◽  
Yuehua Wang ◽  
Yongqiang Quan ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Retrospective Analysis ◽  
High Mortality ◽  
Multidrug Resistant ◽  
Global Public Health ◽  
Candida Auris ◽  
Genetic Classification ◽  
First Case ◽  
History Of ◽  
Underlying Diseases

IntroductionCandida auris is an emerging multidrug-resistant fungus that may cause infections with a high mortality rate. The first case of C. auris infection was reported in 2009 and infections have been reported in 44 countries. The fungus now represents a major global public health threat. We analyzed cases from the emergence of C. auris infections up until the end of 2020. It is hoped that the results of this analysis will raise awareness in scientists to promote protection and control research pertaining to this pathogen.MethodsPubMed and Web of Science databases were searched for all papers related to C. auris infections up until December 31, 2020. We sorted and organized these data into the following categories: date of publication, patient age and sex, underlying diseases, risk factors for infection, patient mortality information, drug sensitivity information of C. auris isolates, and genetic classification. The χ2 test was used to screen for factors that may affect patient mortality.ResultsA total of 912 patients were included in the analysis. There’s a higher proportion of men and a high proportion of patients were premature babies and elderly people. The proportions of patients with underlying diseases such as diabetes, kidney disease, trauma, and ear disease were also high. More than half of patients had a history of central venous catheter use and a history of broad-spectrum antibiotic use. The χ2 test revealed that only kidney disease (P < 0.05) was an important risk factor for mortality in C. auris-infected patients.ConclusionsA comprehensive understanding of C. auris was achieved following this retrospective analysis, including the characteristics of C. auris-infected patients. In recent years, increasing numbers of multidrug-resistant C. auris isolates have been identified, and the high mortality rates associated with infection merit greater attention from the medical world.

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