Screening for Candida auris in patients admitted to eight intensive care units in England, 2017 to 2018

Ashley Sharp, Berit Muller-Pebody, Andre Charlett, Bharatkumar Patel, Rebecca Gorton, Jonathan Lambourne, Martina Cummins, Adela Alcolea-Medina, Mark Wilks, Robin Smith, Damien MacK, Susan Hopkins, Andrew Dodgson, Phillipa Burns, Nelun Perera, Felicia Lim, Gopal Rao, Priya Khanna, Elizabeth Johnson, Andrew BormanSilke Schelenz, Rebecca Guy, Joanna Conneely, Rohini Manuel, Colin S. Brown

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Abstract

Background: Candida auris is an emerging multidrug-resistant fungal pathogen associated with bloodstream, wound and other infections, especially in critically ill patients. C. auris carriage is persistent and is difficult to eradicate from the hospital environment. Aim: We aimed to pilot admission screening for C. auris in intensive care units (ICUs) in England to estimate prevalence in the ICU population and to inform public health guidance. Methods: Between May 2017 and April 2018, we screened admissions to eight adult ICUs in hospitals with no previous cases of C. auris, in three major cities. Swabs were taken from the nose, throat, axilla, groin, perineum, rectum and catheter urine, then cultured and identified using matrix-assisted laser desorption/ionisation time-offlight mass spectrometry (MALDI-TOF MS). Patient records were linked to routine ICU data to describe and compare the demographic and health indicators of the screened cohort with a national cohort of ICU patients admitted between 2016 and 2017. Results: All C. auris screens for 921 adults from 998 admissions were negative. The upper confidence limit of the pooled prevalence across all sites was 0.4%. Comparison of the screened cohort with the national cohort showed it was broadly similar to the national cohort with respect to demographics and co-morbidities. Conclusion: These findings imply that C. auris colonisation among patients admitted to ICUs in England is currently rare. We would not currently recommend widespread screening for C. auris in ICUs in England. Hospitals should continue to screen high-risk individuals based on local risk assessment.

Original languageEnglish
JournalEurosurveillance
Volume26
Issue number8
DOIs
Publication statusPublished - Feb 2021

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