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Candida auris outbreak in a COVID-19 specialty care unit — Florida, July–August 2020
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January 8, 2021
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Series: MMWR; v. 70, ER, 1/8/21
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Description:In July 2020, the Florida Department of Health was alerted to three Candida auris bloodstream infections and one urinary tract infection in four patients with coronaVirus disease 2019 (COVID-19) who received care in the same dedicated COVID-19 unit of an acute care hospital (hospital A). C. auris is a multidrug-resistant yeast that can cause invasive infection. Its ability to colonize patients asymptomatically and persist on surfaces has contributed to previous C. auris outbreaks in health care settings (1–7). Since the first C. auris case was identified in Florida in 2017, aggressive measures have been implemented to limit spread, including contact tracing and screening upon detection of a new case. Before the COVID-19 pandemic, hospital A conducted admission screening for C. auris and admitted colonized patients to a separate dedicated ward.
Hospital A’s COVID-19 unit spanned five wings on four floors, with 12–20 private, intensive care–capable rooms per wing. Only patients with positive test results for SARS-CoV-2, the Virus that causes COVID-19, at the time of admission were admitted to this unit. After patient discharge, room turnover procedures included thorough cleaning of all surfaces and floor and ultraviolet disinfection. In response to the four clinical C. auris infections, unit-wide point prevalence surveys to identify additional hospitalized patients colonized with C. auris were conducted during August 4–18; patients on all four floors were screened sequentially and rescreened only if their initial result was indeterminate. Hospital A’s infection Prevention team, the Florida Department of Health, and CDC performed a joint investigation focused on infection Prevention and control at hospital A that included observation of health care personnel (HCP) use of personal protective equipment (PPE), contact with and disinfection of shared medical equipment, hand hygiene, and Suppl.y storage. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.
Among 67 patients admitted to the COVID-19 unit and screened during point prevalence surveys, 35 (52%) received positive test results. Mean age of colonized patients was 69 years (range = 38–101 years) and 60% were male. Six (17%) colonized patients later had clinical cultures that grew C. auris. Among patients screened who had available medical records (20), two (10%) were admitted directly from a long-term care facility and eight (40%) died within 30 days of screening, but whether C. auris contributed to death is unknown.
Suggested citation for this article: Prestel C, Anderson E, Forsberg K, et al. Candida auris Outbreak in a COVID-19 Specialty Care Unit — Florida, July–August 2020. MMWR Morb Mortal Wkly Rep. ePub: 8 January 2021.
mm7002e3.htm?s_cid=mm7002e3_w
pdfs/mm7002e3-H.pdf
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