TY - JOUR
T1 - Screening for Candida auris in patients admitted to eight intensive care units in England, 2017 to 2018
AU - Sharp, Ashley
AU - Muller-Pebody, Berit
AU - Charlett, Andre
AU - Patel, Bharatkumar
AU - Gorton, Rebecca
AU - Lambourne, Jonathan
AU - Cummins, Martina
AU - Alcolea-Medina, Adela
AU - Wilks, Mark
AU - Smith, Robin
AU - MacK, Damien
AU - Hopkins, Susan
AU - Dodgson, Andrew
AU - Burns, Phillipa
AU - Perera, Nelun
AU - Lim, Felicia
AU - Rao, Gopal
AU - Khanna, Priya
AU - Johnson, Elizabeth
AU - Borman, Andrew
AU - Schelenz, Silke
AU - Guy, Rebecca
AU - Conneely, Joanna
AU - Manuel, Rohini
AU - Brown, Colin S.
N1 - Funding Information:
We received internal funding from Public Health England and external funding from Barts Charity.
Publisher Copyright:
© 2021 European Centre for Disease Prevention and Control (ECDC). All rights reserved.
PY - 2021/2/25
Y1 - 2021/2/25
N2 - 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.
AB - 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.
KW - COLONIZATION
UR - http://www.scopus.com/inward/record.url?scp=85102095324&partnerID=8YFLogxK
U2 - 10.2807/1560-7917.ES.2021.26.8.1900730
DO - 10.2807/1560-7917.ES.2021.26.8.1900730
M3 - Article
C2 - 33632376
AN - SCOPUS:85102095324
SN - 1025-496X
VL - 26
SP - 2
EP - 9
JO - Eurosurveillance
JF - Eurosurveillance
IS - 8
ER -
