How two California hospitals prevented the spread of a deadly fungal infection during the pandemic


Candida albicans, which is related to Candida auris. Credit: CDC

In the midst of the COVID-19 pandemic, infection preventionists at two hospitals in Southern California took extreme steps to stop the spread of a deadly fungus that has sprung up in the U.S. and around the world. The two will detail their proactive responses in oral presentations today at the Association of Infection Control and Epidemiology Professionals (APIC), 48th Annual Conference.

In separate responses, Scripps Memorial in La Jolla and UCLA Health in Los Angeles isolated suspects or confirmed , worked closely with public health departments and the information technology and laboratory teams at its facilities and implemented aggressive measures to prevent the pathogen, Candida auris, from the broadcast.

“The fact that these two teams recognized this threat and were able to mobilize so quickly and effectively, while also being on high alert for COVID, is remarkable,” said Ann Marie Pettis, President of APIC 2021, BSN, RN, CIC, FAPIC. “His demonstrate the importance of sufficient hospitals, clinics, and long-term care centers preventionists and resources to train personnel and control security protocols so that they can prevent damage on several fronts. “

C. auris it is a type of fungus that causes serious, often fatal infections, and is resistant to most antifungal drugs. It can be transported to a patient’s skin and can survive on surfaces for more than a month, allowing it to spread easily among patients. Most hospital disinfectants cannot kill C. auris, making it difficult to eradicate the health environment. It is also easy to misidentify in laboratory tests.

In March 2020, during the initial influx of patients with COVID-19, Elizabeth A. Jefferson, BS, Ph.D., CIC, of ​​the Scripps Memorial Infection Prevention, was notified that her facility had received the first known case of C. auris in San Diego County.

Initially marked and isolated because the patient had received health care abroad, as confirmed by laboratory tests C. auris in a wound. The patient remained hospitalized in isolation for 47 days, during which time the team implemented aggressive cleaning measures, including the use of a disinfectant that was effective against C. auris and UV light for terminal cleaning of all patient rooms.

“Staff education was essential,” Jefferson said. “The staff had to clean and disinfect the room twice a day and then clean any shared equipment, because if Candida auris set up shop on their premises, it is extremely difficult to get rid of them “.

The team partnered with public health, including the CDC’s network of antibiotic resistance labs, in routine surveillance tests to make sure there was no transmission.

“Hospitals need to be on the lookout C. auris“Jefferson said.” You do not know if a patient is colonized or infected unless you have specialized laboratory equipment. “

As a result, there has been no transmission of the fungal pathogen that has infected nearly 1,800 patients in 15 states and the District of Columbia since it was first detected in the U.S. in 2015.

When C. auris began to rise in Southern California during the summer of 2020, UCLA Health was ready. Know the devastation C. auris they had provoked in other states, they had already created a multi-level notification system designed to capture possible cases early and prevent transmission.

Collaborating with their electronic medical records (EMR) team and laboratory, infection preventionists ensured that the EMR system was configured to examine all patients for both COVID and Candida auris when they entered the facility. High-risk patients were marked and tested appropriately with subsequent notifications sent to infection prevention, environmental services, the laboratory, and the infirmary. The placed system is kept in patient letters prior to discharge or transfer to allow communication with the health department and reception facilities about the patient C. auris state.

The system activated reminders of strict cleaning protocols that included testing of environmental surfaces after terminal cleaning to make sure the patient’s room was free of the body.

“Have an internal laboratory for testing C. auris and collaborating with the EMR team to create a set of detection steps for our EMR created a safe way to ensure we could monitor and track any suspicions C. auris cases in our facilities. This process was effective in preventing cross-contamination in the healthcare environment, ”said Urvashi Parti, MPH, infection prevention at UCLA Health.

Another success factor was the participation of senior leaders, so they understood the importance of controlling them both. C. auris and COVID at the same time.

“We had the full support of the top leaders who made sure we had the resources to support the early identification of C. auris during the COVID-19 pandemic, ”said Shaunte Walton, EM, CIC, director of the health system of clinical epidemiology and infection prevention at UCLA Health.

Candida auris is a new drug-resistant fungus that is emerging worldwide

Provided by the Association for Infection Control Professionals

Citation: How two California hospitals prevented the spread of a deadly fungal infection during the pandemic (2021, June 29) recovered on June 29, 2021 at -hospitals-deadly-fungal-infection .html

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