Screening for Candida auris in patients admitted to eight intensive care units in England, 2017 to 2018

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 26; no. 8; p. 1
• Main Authors: Sharp, Ashley, Muller-Pebody, Berit, Charlett, Andre, Patel, Bharat, Gorton, Rebecca, Lambourne, Jonathan, Cummins, Martina, Alcolea-Medina, Adela, Wilks, Mark, Smith, Robin, Mack, Damien, Hopkins, Susan, Dodgson, Andrew, Burns, Phillipa, Perera, Nelun, Lim, Felicia, Rao, Gopal, Khanna, Priya, Johnson, Elizabeth, Borman, Andrew, Schelenz, Silke, Guy, Rebecca, Conneely, Joanna, Manuel, Rohini J, Brown, Colin S
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 25.02.2021; European Centre for Disease Prevention and Control (ECDC)
• Subjects: Adult; Antifungal Agents - pharmacology; Antifungal Agents - therapeutic use; Candida; Candidiasis - diagnosis; Candidiasis - drug therapy; Candidiasis - epidemiology; Critical care; England - epidemiology; Fungal infections; Fungi; Humans; Intensive Care Units; Medical screening; Microbial Sensitivity Tests; Patients; Public health; Surveillance; England; United Kingdom > UK; Candida auris; intensive care; antimicrobial resistance; emerging infection; hospital-associated infection
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES.2021.26.8.1900730

Background is an emerging multidrug-resistant fungal pathogen associated with bloodstream, wound and other infections, especially in critically ill patients. carriage is persistent and is difficult to eradicate from the hospital environment.AimWe aimed to pilot admission screening for in intensive care units (ICUs) in England to estimate prevalence in the ICU population and to inform public health guidance.MethodsBetween May 2017 and April 2018, we screened admissions to eight adult ICUs in hospitals with no previous cases of in three major cities. Swabs were taken from the nose, throat, axilla, groin, perineum, rectum and catheter urine, then cultured and identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Patient records were linked to routine ICU data to describe and compare the demographic and health indicators of the screened cohort with a national cohort of ICU patients admitted between 2016 and 2017.ResultsAll screens for 921 adults from 998 admissions were negative. The upper confidence limit of the pooled prevalence across all sites was 0.4%. Comparison of the screened cohort with the national cohort showed it was broadly similar to the national cohort with respect to demographics and co-morbidities.ConclusionThese findings imply that colonisation among patients admitted to ICUs in England is currently rare. We would not currently recommend widespread screening for in ICUs in England. Hospitals should continue to screen high-risk individuals based on local risk assessment.