John Rossow1,2, Belinda Ostrowsky3, Eleanor Adams4, Jane Greenko4, Robert McDonald1,5, Snigdha Vallabhaneni2,3, Kaitlin Forsberg2, Stephen Perez1, Todd Lucas1, Karen A Alroy1, Kara Jacobs Slifka3, Maroya Walters3, Brendan R Jackson2, Monica Quinn5, Sudha Chaturvedi6,7, Debra Blog5,7. 1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 2. Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 3. Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 4. New York State Department of Health, Metropolitan Area Regional Office, New Rochelle, New York, USA. 5. New York State Department of Health, Albany, New York, USA. 6. Wadsworth Laboratory, Albany, New York, USA. 7. Albany School of Public Health, Albany, New York, USA.
Abstract
BACKGROUND: Candida auris is an emerging, multidrug-resistant yeast that spreads in healthcare settings. People colonized with C. auris can transmit this pathogen and are at risk for invasive infections. New York State (NYS) has the largest US burden (>500 colonized and infected people); many colonized individuals are mechanically ventilated or have tracheostomy, and are residents of ventilator-capable skilled nursing facilities (vSNF). We evaluated the factors associated with C. auris colonization among vSNF residents to inform prevention interventions. METHODS: During 2016-2018, the NYS Department of Health conducted point prevalence surveys (PPS) to detect C. auris colonization among residents of vSNFs. In a case-control investigation, we defined a case as C. auris colonization in a resident, and identified up to 4 residents with negative swabs during the same PPS as controls. We abstracted data from medical records on patient facility transfers, antimicrobial use, and medical history. RESULTS: We included 60 cases and 218 controls identified from 6 vSNFs. After controlling for potential confounders, the following characteristics were associated with C. auris colonization: being on a ventilator (adjusted odds ratio [aOR], 5.9; 95% confidence interval [CI], 2.3-15.4), receiving carbapenem antibiotics in the prior 90 days (aOR, 3.5; 95% CI, 1.6-7.6), having ≥1 acute care hospital visit in the prior 6 months (aOR, 4.2; 95% CI, 1.9-9.6), and receiving systemic fluconazole in the prior 90 days (aOR, 6.0; 95% CI, 1.6-22.6). CONCLUSIONS: Targeted screening of patients in vSNFs with the above risk factors for C. auris can help identify colonized patients and facilitate the implementation of infection control measures. Antimicrobial stewardship may be an important factor in the prevention of C. auris colonization. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
BACKGROUND:Candida auris is an emerging, multidrug-resistant yeast that spreads in healthcare settings. People colonized with C. auris can transmit this pathogen and are at risk for invasive infections. New York State (NYS) has the largest US burden (>500 colonized and infectedpeople); many colonized individuals are mechanically ventilated or have tracheostomy, and are residents of ventilator-capable skilled nursing facilities (vSNF). We evaluated the factors associated with C. auris colonization among vSNF residents to inform prevention interventions. METHODS: During 2016-2018, the NYS Department of Health conducted point prevalence surveys (PPS) to detect C. auris colonization among residents of vSNFs. In a case-control investigation, we defined a case as C. auris colonization in a resident, and identified up to 4 residents with negative swabs during the same PPS as controls. We abstracted data from medical records on patient facility transfers, antimicrobial use, and medical history. RESULTS: We included 60 cases and 218 controls identified from 6 vSNFs. After controlling for potential confounders, the following characteristics were associated with C. auris colonization: being on a ventilator (adjusted odds ratio [aOR], 5.9; 95% confidence interval [CI], 2.3-15.4), receiving carbapenem antibiotics in the prior 90 days (aOR, 3.5; 95% CI, 1.6-7.6), having ≥1 acute care hospital visit in the prior 6 months (aOR, 4.2; 95% CI, 1.9-9.6), and receiving systemic fluconazole in the prior 90 days (aOR, 6.0; 95% CI, 1.6-22.6). CONCLUSIONS: Targeted screening of patients in vSNFs with the above risk factors for C. auris can help identify colonized patients and facilitate the implementation of infection control measures. Antimicrobial stewardship may be an important factor in the prevention of C. auris colonization. Published by Oxford University Press for the Infectious Diseases Society of America 2020.
Authors: Samantha E Jacobs; Jonathan L Jacobs; Emily K Dennis; Sarah Taimur; Meenakshi Rana; Dhruv Patel; Melissa Gitman; Gopi Patel; Sarah Schaefer; Kishore Iyer; Jang Moon; Victoria Adams; Polina Lerner; Thomas J Walsh; YanChun Zhu; Mohammed Rokebul Anower; Mayuri M Vaidya; Sudha Chaturvedi; Vishnu Chaturvedi Journal: Antimicrob Agents Chemother Date: 2022-06-30 Impact factor: 5.938
Authors: Sarah Kabbani; Stanley W Wang; Laura L Ditz; Katryna A Gouin; Danielle Palms; Theresa A Rowe; David Y Hyun; Nancy W Chi; Nimalie D Stone; Lauri A Hicks Journal: Antimicrob Steward Healthc Epidemiol Date: 2021-12-07
Authors: Zena Lapp; Ryan Crawford; Arianna Miles-Jay; Ali Pirani; William E Trick; Robert A Weinstein; Mary K Hayden; Evan S Snitkin; Michael Y Lin Journal: Clin Infect Dis Date: 2021-10-20 Impact factor: 9.079
Authors: Xin Huang; Rory M Welsh; Clay Deming; Diana M Proctor; Pamela J Thomas; Gabrielle M Gussin; Susan S Huang; Heidi H Kong; Meghan L Bentz; Snigdha Vallabhaneni; Tom Chiller; Brendan R Jackson; Kaitlin Forsberg; Sean Conlan; Anastasia P Litvintseva; Julia A Segre Journal: mSphere Date: 2021-08-04 Impact factor: 4.389