Candida auris Outbreak in a Large Public Hospital in the City of Recife, Pernambuco State, Northeast Region of Brazil, November 2021 to January 2022
- Healthcare related infections
- Anti-microbial resistance
- Other
Background
Candida auris is an emerging yeast of global health importance, due to its multidrug-resistant capacity to the main antifungal classes. In December 2021, two cases of C. auris infection were reported in a large public hospital in the city of Recife, Pernambuco State, Brazil. The objectives were to describe the outbreak, to identify new cases through contact tracing and to recommend prevention and control measures.
Methods
We carried out a descriptive study between November 21, 2021 and January 31, 2022. Patients who had C. auris identification in clinical samples or surveillance cultures using the MALDI-TOF mass spectrometry were considered cases. Contact tracing was performed for patients hospitalized in hospital sectors where a confirmed case was admitted, provided that the contacts were using invasive devices, with three or more days of hospitalization. We collected data from medical records and used descriptive statistics to evaluate the results.
Results
We confirmed four cases and, of these, 2/4 were identified through contact tracing. Three were men and three were admitted to the Intensive Care Unit (ICU). The median age was 57.5 years (minimum: 38 – maximum: 70). The four cases used invasive devices, had a hospital stay of more than 30 days and used broad-spectrum antibiotics; 2/4 showed signs of candidemia and 1/4 died from subarachnoid hemorrhage.
Conclusion
The identification of new cases of infection by C. auris indicated that the etiological agent remained in circulation in the hospital. This information strengthened the timely adoption of measures such as contact precautions and reinforcement of surfaces disinfection. Evidence suggested that ICU admission may have led to the risk of colonization. We recommended to continue contact tracing, maintenance of disinfection of surfaces and monitoring of the clinical evolution of patients.
Candida auris is an emerging yeast of global health importance, due to its multidrug-resistant capacity to the main antifungal classes. In December 2021, two cases of C. auris infection were reported in a large public hospital in the city of Recife, Pernambuco State, Brazil. The objectives were to describe the outbreak, to identify new cases through contact tracing and to recommend prevention and control measures.
Methods
We carried out a descriptive study between November 21, 2021 and January 31, 2022. Patients who had C. auris identification in clinical samples or surveillance cultures using the MALDI-TOF mass spectrometry were considered cases. Contact tracing was performed for patients hospitalized in hospital sectors where a confirmed case was admitted, provided that the contacts were using invasive devices, with three or more days of hospitalization. We collected data from medical records and used descriptive statistics to evaluate the results.
Results
We confirmed four cases and, of these, 2/4 were identified through contact tracing. Three were men and three were admitted to the Intensive Care Unit (ICU). The median age was 57.5 years (minimum: 38 – maximum: 70). The four cases used invasive devices, had a hospital stay of more than 30 days and used broad-spectrum antibiotics; 2/4 showed signs of candidemia and 1/4 died from subarachnoid hemorrhage.
Conclusion
The identification of new cases of infection by C. auris indicated that the etiological agent remained in circulation in the hospital. This information strengthened the timely adoption of measures such as contact precautions and reinforcement of surfaces disinfection. Evidence suggested that ICU admission may have led to the risk of colonization. We recommended to continue contact tracing, maintenance of disinfection of surfaces and monitoring of the clinical evolution of patients.