Introduction: Candida auris is an emerging and multi-drug resistant pathogen recently associated with outbreaks worldwide, often in intensive care settings. We describe our experience of patient and environmental screening during an outbreak in the Neurological Intensive Care Unit (NITU) of a large teaching hospital Trust. Methods: Patients were screened on admission to the NITU, weekly and on discharge from October 2016 to May 2017. Various methodologies for environmental screening were used with an emphasis on sampling high-touch areas and multi-use devices. Results: Between the end of October 2016 to the end of May 2017 fifty-eight patients became C. auris colonised or infected, including two cases of candidaemia. Fifty-seven of the 58 patients colonised or infected with C. auris had been admitted to NITU during their hospital stay. C. auris detection in the NITU ward environment was low. However, the organism was detected from multiuse patient monitoring equipment (skin surface temperature probes and a pulse oximeter) and a patient hoist. Following the initial finding of C. auris on a skin surface temperature probe, C. auris was cultured from four further temperature probes. Discussion: We provide evidence that C. auris can be recovered from ‘cleaned’ skin surface temperature probes supporting the hypothesis that re-usable equipment is a risk factor for colonisation/infection with this organism. The use of skin surface temperature probes has been discontinued on the unit. Removal of the temperature probes appears to reduce the acquisition rate. Our initial observations will be further investigated by conducting a cohort study examining risk factors for colonisation and infection.
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Madder et al. (2017) studied this question.