385. The Value Added from Candida auris Point Prevalence and Environmental Studies in New York State
Session: Poster Abstract Session: Fungal Disease: Management and Outcomes
Thursday, October 4, 2018
Room: S Poster Hall
Background:

As of 3/25/18, 151 clinical cases of C. auris were diagnosed in NYS. We conducted point prevalence surveys (PPS) and environmental surveys (ES) to detect surveillance cases and assess the burden of environmental contamination in NYS healthcare facilities from 9/12/16.

Methods:

A PPS was defined as culturing ≥2 individuals at a healthcare facility that diagnosed, cared for, or was near a facility with a C. auris case. ES involved environmental swabbing in facilities where cases resided or were admitted. Cultures and polymerase chain reaction (PCR) were performed at the NYS Wadsworth Center.

Results:

As of 3/25/18, 81 PPS or ES had been conducted at 55 facilities. From these PPS, a total of 144 (6.1%) individuals were positive for C. auris by culture; 125 were PCR positive. The rates of culture positive C. auris identified patients varied by facility type: hospitals (38/767, 5.0%), long term care facilities (LTCF) (88/1404, 6.3%), long term acute care (1/35, 2.9%), and co-located hospital and LTCF (17/138, 12.3%). The majority of the LTCF C. auris culture-positive cases (80/82) were identified in facilities that cared for ventilated patients. Rates in LTCF caring for ventilated patients were nearly ten times as high as other LTCF [86/1121 (7.7%) vs. 2/284 (0.7%)]. ES identified 86 (3.0%) samples positive by culture and 257 (8.9%) by PCR. Thirty-seven (67%) of the 55 facilities had at least one positive environmental sample by PCR or culture; many of these positive samples were from surfaces or equipment deemed to be “clean.” Over 1900 person-hours were needed to conduct onsite PPS and ES that collected >4200 human and >2800 environmental samples and identified opportunities for improving basic infection prevention and environmental cleaning. Ten facilities, including the co-located hospital and LTCF, had multiple positive PPS or ES.

Conclusion:

PPS conducted over 17 months detected many colonized individuals and C. auris in facility environments, likely indicating a silent reservoir for this organism beyond clinical cases, especially in LTCFs. Serial PPS and ES can help improve C. auris detection and inform subsequent infection prevention and control interventions. However, these efforts are resource intensive and can divert resources from other activities.

Eleanor H. Adams, MD, MPH1, Monica Quinn, RN, MS, CIC2, Belinda Ostrowsky, MD, MPH3, Karen Southwick, MD4, Jane Greenko, RN, MPH, CIC5, Rafael Fernandez, MPH6, Rutvik Patel, MSW1, Ronald Jean Denis, BS1, Richard Erazo, BS1, Sudha Chaturvedi, PhD7, Lynn Leach, MS7, Yan Chun Zhu, MS7, Valerie B. Haley, PhD2, Sharon Tsay, MD8, Snigdha Vallabhaneni, MD, MPH9, Emily C. Lutterloh, MD, MPH2, Debra S. Blog, MD, MPH10 and Elizabeth M. Dufort, MD10, (1)Healthcare Epidemiology & Infection Control, New York State Department of Health, New Rochelle, NY, (2)Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY, (3)Dhqp, Centers for Disease Control and Prevention, NY, NY, (4)New York State Department of Health, Albany, NY, (5)Healthcare Epidemiology & Infection Control, New York State Department of Health, Central Islip, NY, (6)Healthcare Epidemiology & Infection Control, New York State Department of Health, New York, NY, (7)Wadsworth Center, New York State Department of Health, Albany, NY, (8)Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, (9)Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, (10)Division of Epidemiology, New York State Department of Health, Albany, NY

Disclosures:

E. H. Adams, None

M. Quinn, None

B. Ostrowsky, None

K. Southwick, None

J. Greenko, None

R. Fernandez, None

R. Patel, None

R. Jean Denis, None

R. Erazo, None

S. Chaturvedi, None

L. Leach, None

Y. C. Zhu, None

V. B. Haley, None

S. Tsay, None

S. Vallabhaneni, None

E. C. Lutterloh, None

D. S. Blog, None

E. M. Dufort, None

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