To get us in the mood for Dr Nneoma Okeke’s Journal Club tomorrow (register here!), I’ve been reading the paper that will be covered. Over the past two decades, a huge population-based study in Queensland, Australia sheds light on the evolving landscape of Candida and Candida-like species bloodstream infections. This analysis, including 2,586 episodes across 2,420 patients, reveals critical trends in species prevalence, resistance patterns, gender differences, and clinical outcomes that have significant implications for healthcare practices.
Continue reading#candida
C. auris is now the preeminent cause of HCAI outbreaks in Saudi Arabia
I was browsing pubmed this morning for updates related to C. auris from outside the UK, and came across this fascinating report from Saudi Arabia. Based on national notifications to the Saudi Arabian Ministry of Health, C. auris was the preeminent cause of HCAI outbreaks during 2023!
Continue readingCandida auris and surface survival
Candida auris is an emerging threat to healthcare facilities worldwide. Recent, worrying, data from the US suggests that prevalence is increasing rapidly. So, we need to make sure we have every prevention base covered to reduce the chances of cross-transmission. C. auris seems to be quite an environmental organism – and a recent JHI study confirms this, showing extended survival on surfaces and tolerance to low concentrations of some biocides.
Continue readingC. auris questionnaire – the outcome
Overall 61 colleagues from 17 countries answered the questionnaire. A large proportion (26 of 61) of the answers came from the UK, which might have to do with the fact that the first European outbreak was described in England.
Of the respondents 32.8% said that their institution released a warning about C. auris. Analyzing the data separately for the UK and the other participating countries, it became clear that the first European outbreak had impact on the preparedness. In the UK 42.3% of the institutions were warned about the unique capacities of C. auris, versus 25.7 in all other countries. Regarding the existence of a written guideline dealing with C. auris, the differences were far less pronounced, namely 26.9% versus 20.0%, respectively.
53.9% of the UK responders believe that their lab can correctly diagnose C. auris, versus 31.4% in the other countries. In addition, the proportion of responders, who didn’t know if their lab was prepared, was higher outside the UK (45.7% versus 26.9%, respectively).
Despite the emerging spread of C. auris clusters this questionnaire is an indication that most institutions are not adequately prepared. Obviously the sample is really small, but the outcome was predictable. With an increasing body of literature, including papers on diagnostic methods and infection control measures, we should hope that the situation should change very soon. Thus, don’t lean back, start writing.
Candida auris part III. Are you prepared?
MMWR just published on the ongoing transmission of Candida auris in the US, while at the same time PLOS Pathogens came with an excellent review on the topic.
By now I had the debatable pleasure to be around for the birth of a few “superbugs”, but this one is clearly putting a lot of effort into reaching the top of the list. I believe (classical pessimist) that many institutions still ignore this new adversary (or are even unaware), and most certainly have no game-plan to prevent its introduction and consequent spread. In the MMWR publication the current recommendations for C. auris–colonized or infected patients were repeated, with only one change from previous recommendations, namely that a more effective (sporicidal) disinfectant is needed, but I seriously wonder who follows this guidance.
Thus, here it comes, another 30-seconds-questionaire. Why? Because I hope that you will prove me wrong and that we – the infection control people at the frontline – act on threat, instead of re-act once we are overrun.
Link to questions https://www.surveymonkey.com/r/QCK9RWS
References
Notes from the Field: Ongoing Transmission of Candida auris in Health Care Facilities — United States, June 2016–May 2017. Weekly / May 19, 2017 / 66(19);514–515 https://www.cdc.gov/mmwr/volumes/66/wr/mm6619a7.htm?s_cid=mm6619a7_e
Chowdhary A, Sharma C, Meis J. Candida auris: A rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally. PLOS Pathogens https://doi.org/10.1371/journal.ppat.1006290 May 18, 2017
Superfungus (Candida auris)
The Royal Brompton in London report a 50 case outbreak of C. auris, and a range of IPC measures that you would expect to prevent further transmission, but failed to do so. What’s so special about Candida auris? Is it a superfungus?
Reflections on Infection Prevention and Control 