D Joseph Sexton1, Meghan L Bentz1, Rory M Welsh1, Gordana Derado2, William Furin3, Laura J Rose3, Judith Noble-Wang3, Massimo Pacilli4, Tristan D McPherson4,5, Stephanie Black4, Sarah K Kemble4, Owen Herzegh6, Ausaf Ahmad6, Kaitlin Forsberg1, Brendan Jackson1, Anastasia P Litvintseva1. 1. Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA. 2. Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 3. Clinical and Environmental Microbiology Branch, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. 4. Chicago Department of Public Health, Chicago, IL, USA. 5. Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA. 6. Enhanced Capacity Surge Laboratory, Reagent and Diagnostic Services Branch, Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Centers for Disease Control & Prevention (CDC), Atlanta, GA, USA.
Abstract
BACKGROUND: Candida auris is an emerging multidrug-resistant yeast that contaminates healthcare environments causing healthcare-associated outbreaks. The mechanisms facilitating contamination are not established. METHODS: C. auris was quantified in residents' bilateral axillary/inguinal composite skin swabs and environmental samples during a point-prevalence survey at a ventilator-capable skilled-nursing facility (vSNF A) with documented high colonization prevalence. Environmental samples were collected from all doorknobs, windowsills and handrails of each bed in 12 rooms. C. auris concentrations were measured using culture and C. auris-specific qPCR. The relationship between C. auris concentrations in residents' swabs and associated environmental samples were evaluated using Kendall's tau-b (τb) correlation coefficient. RESULTS: C. auris was detected in 70 /100 tested environmental samples and 31/ 57 tested resident skin swabs. The mean C. auris concentration in skin swabs was 1.22 x 10 5 cells/mL by culture and 1.08 x 10 6 cells/mL by qPCR. C. auris was detected on all handrails of beds occupied by colonized residents, as well as 10/24 doorknobs and 9/12 windowsills. A positive correlation was identified between the concentrations of C. auris in skin swabs and associated handrail samples based on culture (τb = 0.54, p = 0.0004) and qPCR (τb = 0.66, p = 3.83e -6). Two uncolonized residents resided in beds contaminated with C. auris. CONCLUSIONS: Colonized residents can have high C. auris burdens on their skin, which was positively related with contamination of their surrounding healthcare environment. These findings underscore the importance of hand hygiene, transmission-based precautions, and particularly environmental disinfection in preventing spread in healthcare facilities.
BACKGROUND:Candida auris is an emerging multidrug-resistant yeast that contaminates healthcare environments causing healthcare-associated outbreaks. The mechanisms facilitating contamination are not established. METHODS:C. auris was quantified in residents' bilateral axillary/inguinal composite skin swabs and environmental samples during a point-prevalence survey at a ventilator-capable skilled-nursing facility (vSNF A) with documented high colonization prevalence. Environmental samples were collected from all doorknobs, windowsills and handrails of each bed in 12 rooms. C. auris concentrations were measured using culture and C. auris-specific qPCR. The relationship between C. auris concentrations in residents' swabs and associated environmental samples were evaluated using Kendall's tau-b (τb) correlation coefficient. RESULTS:C. auris was detected in 70 /100 tested environmental samples and 31/ 57 tested resident skin swabs. The mean C. auris concentration in skin swabs was 1.22 x 10 5 cells/mL by culture and 1.08 x 10 6 cells/mL by qPCR. C. auris was detected on all handrails of beds occupied by colonized residents, as well as 10/24 doorknobs and 9/12 windowsills. A positive correlation was identified between the concentrations of C. auris in skin swabs and associated handrail samples based on culture (τb = 0.54, p = 0.0004) and qPCR (τb = 0.66, p = 3.83e -6). Two uncolonized residents resided in beds contaminated with C. auris. CONCLUSIONS: Colonized residents can have high C. auris burdens on their skin, which was positively related with contamination of their surrounding healthcare environment. These findings underscore the importance of hand hygiene, transmission-based precautions, and particularly environmental disinfection in preventing spread in healthcare facilities.
Authors: Jeffrey M Rybak; Katherine S Barker; José F Muñoz; Josie E Parker; Suhail Ahmad; Eiman Mokaddas; Aneesa Abdullah; Rehab S Elhagracy; Steve L Kelly; Christina A Cuomo; P David Rogers Journal: Clin Microbiol Infect Date: 2021-12-13 Impact factor: 13.310
Authors: Benjamin Williamson; Adam Wilk; Kevin D Guerrero; Timothy D Mikulski; Tony N Elias; Indira Sawh; Geselle Cancino-Prado; Dianne Gardam; Christopher H Heath; Nelesh P Govender; David S Perlin; Milena Kordalewska; Kelley R Healey Journal: Antimicrob Agents Chemother Date: 2021-10-11 Impact factor: 5.938