161. Prevalence and Risk Factors for Candida auris Colonization Among Patients in a Long Term Acute Care Hospital — New Jersey, 2017
Session: Oral Abstract Session: Healthcare Epidemiology: Special Populations
Thursday, October 4, 2018: 11:00 AM
Room: S 156

Background: Candida auris can be transmitted in healthcare settings, and patients can become asymptomatically colonized, increasing risk for invasive infection and transmission. We investigated an ongoing C. auris outbreak at a 30-bed long-term acute care hospital to identify colonization for C. auris prevalence and risk factors.

Methods: During February–June, 2017, we conducted point prevalence surveys every two weeks among admitted patients. We abstracted clinical information from medical records and collected axillary and groin swabs. Swabs were tested for C. auris. Data were analyzed to identify risk factors for colonization with C. auris by evaluating differences between colonized and non-colonized patients.

Results: All 101 hospitalized patients were surveyed, 33 (33%) were colonized with C. auris. Prevalence of colonization ranged from 8%–38%; incidence ranged from 5%-20% (Figure). Among colonized patients with available data, 19/27 (70%) had a tracheostomy, 20/31 (65%) had gastrostomy tubes, 24/33 (73%) ventilator use, and 12/27 (44%) had hemodialysis. Also, 31/33 (94%) had antibiotics and 13/33 (34%) antifungals during hospitalization. BMI for colonized patients (Mean (M)=30.3, Standard Deviation (SD)=10) was higher than for non-colonized patients (M=26.5, SD=7.9); t=-2.1, p = 0.04). Odds of colonization were higher among Black patients (33%) vs White patients (16%), (odds ratio [OR] 3.5; 95% confidence interval [CI] 1.3–9.8), and those colonized with other multidrug-resistant organism (MDRO) (72%) vs non-colonized (44%); (OR 3.2; CI 1.3–8.0). Odds of death were higher among colonized patients (OR 4.6; CI 1.6—13.6).

Conclusion: Patients in long term acute care facilities and having high prevalences of MDROs might be at risk for C. auris. Such patients with these risk factors could be targeted for enhanced surveillance to facilitate early detection of C. auris. Infection control measures to reduce MDROs’ spread, including hand hygiene, contact precautions, and judicious use of antimicrobials could prevent further C. auris transmission.

 

Acknowledgements

Janet Glowicz, Kathleen Ross

 

Figure 1: Incidence and prevalence of Candida auris colonization by point prevalence survey (PPS), at a long term acute care hospital, New Jersey, February 28 – June 14, 2017 (N = 101)

 

Faye Rozwadowski, MD1, Jarred McAteer, MD2, Nancy A. Chow, PhD3, Kimberly Skrobarcek, MD4, Kaitlin Forsberg, MPH5, Patricia M. Barrett, MSD6, Rebecca Greeley, MPH6, Tara Fulton, MPH6, Julia Wells, MPH6, Rory M. Welsh, PhD3, Stephanie Dietz, PhD7, Gordana Derado, PhD8, Brendan R. Jackson, MD, MPH3 and Snigdha Vallabhaneni, MD, MPH3, (1)New Jersey Department of Health, Centers for Disease Control and Prevention, Trenton, NJ, (2)Waterborne Disease Prevention Branch, Centers for Disease Control and Prevention, Atlanta, GA, (3)Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, (4)Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, (5)IHRC, Inc, Atlanta, GA, (6)New Jersey Department of Health, Trenton, NJ, (7)Epidemiology Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA, (8)Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

F. Rozwadowski, None

J. McAteer, None

N. A. Chow, None

K. Skrobarcek, None

K. Forsberg, None

P. M. Barrett, None

R. Greeley, None

T. Fulton, None

J. Wells, None

R. M. Welsh, None

S. Dietz, None

G. Derado, None

B. R. Jackson, None

S. Vallabhaneni, None

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