Methods: An electronic survey with 5 IPAC and 12 MICRO questions was sent out to IPAC and MICRO leads for all CNISP sites in January 2018. Data were entered and analyzed in Excel.
Results: We received 32 IPAC surveys representing 58/66 (88%) CNISP hospitals, and 27 MICRO surveys representing 27/32 (84%) CNISP labs. 4/58 (7%) hospitals have a written policy for C. auris screening of patients; and 22 (38%) recommend screening; most commonly: roommates of any patient colonized/infected with any C. auris (n=7), room/wardmates (RWM) of patients colonized/infected with any C. auris (n=7) or RWM of patients with MDR C. auris (n=3). Without resource limitations, 50 (86%) hospitals would screen RWM of C. auris patients and 34 (59%) would screen patients previously hospitalized in the Indian subcontinent.
Overall, 13/27 (48%) labs identify all clinically significant Candida spp. to the species level and 13 identify sterile site (SS) isolates. 22 (81%) labs use MALDI-TOF for identification: 10 Bruker Biotyper and 12 VitekMS . 26 (96%) labs refer non-identified species and commonly misidentified yeast from SS for definitive identification. 23 (85%) labs perform antifungal susceptibility testing for all Candida from blood and CSF. 22 (81%) labs are confident that their current laboratory protocol would identify C. auris if the isolate is from a SS, 17 (63%) if identified as being resistant to at least 1 antifungal and 20 (74%) if the isolate is from a non-SS culture and is identified to the species level. 4 (15%) labs have a protocol for C. auris colonization detection. 4 labs have identified 6 C. auris isolates: 2 reported retrospective identification of 3 fluconazole susceptible C. auris; and 2 reported 1 resistant and 2 MDR isolates identified prospectively in 2017/18.
Conclusion: MDR C. auris have been identified in Canada. Gaps remain in ensuring reliable identification of C. auris, particularly from non-SS, and most IPAC CNISP teams and MICRO do not yet have protocols for identification of C. auris colonization.
F. Garcia Jeldes,
A. Bharat, None
R. Mitchell, None