Caitlyn Stulpin , 2025-05-02 19:58:00
Key takeaways:
- Researchers expanded C. auris screenings outside of outbreaks to include specific patient populations considered high risk.
- 13 cases were identified before expanded screening began vs. 57 after implementation.
ORLANDO — Expanding Candida auris screening to include patients in the ICU or those with indwelling medical devices led to more cases being identified in a Kentucky hospital, according to data presented at SHEA Spring.
“We wanted to take a look at our surveillance screening program and see how effective it actually was in capturing new C. auris patients and see if it was doing what we wanted it to do,” Faith Fursman, BPH, MPH student and infection prevention technician at University of Kentucky HealthCare (UKHC), told Healio.
Data derived from Fursman F, et al. Abstract 171. Presented at: SHEA Spring; April 27-30, 2025; Orlando.
To do so, Fursman and colleagues conducted a retrospective observational study using data from all adult patients age screened for C. auris at UKHC between July 1, 2021, and June 30, 2024. According to the researchers, the study covered two time periods — the period prior to February 2023 when C. auris screening was only conducted during outbreak investigations and a post-implementation period during which C. auris screening was expanded to include ICU admissions, patients from external facilities with wounds or tracheostomies and patients with a history of carbapenem-resistant organism infection. During screenings axillary and groin swabs were collected and tested via PCR. Once cases were identified, they were classified as community-onset — taking place fewer than 4 days after admission — or hospital-onset — taking place 4 days or more after admission.
In total, 13,642 C. auris tests were performed throughout the entire study period, leading to the identification of 70 positive cases — 13 cases during pre-implementation of which six were community-onset and seven hospital-onset, and 57 cases post-implementation of which 31 were community-onset and 26 were hospital-onset.
According to the study, the main indications for screening patients included ICU admission (42.86%), point prevalence surveys (17.14%) and admission from external facilities with wounds (5.72%).
Among all the identified cases, 10 (14.29%) were classified as clinical infections and 60 (85.71%) as colonization.
Fursman said that the study revealed there were a lot of prevalent factors in clinical vs. colonization patients. For example, patients with clinical cases were more likely to have diabetes (90% vs. 48.33%; P = .0143) and indwelling medical devices including tracheostomy (80% vs. 45%; P = .0404), gastrostomy tubes (90% vs. 53.33%; P = .0293), central lines (60% vs. 41.67%) and urinary catheters (60% vs. 46.67%).
She added that they also found a high prevalence of hypertension and chronic obstructive pulmonary disease or emphysema; however, Fursman said those conditions are heavily prevalent in Kentucky where the study was conducted.
The study also showed that 30-day mortality was higher among clinical cases vs. colonized cases, although the researchers noted that the difference was not statistically significant (30% vs. 25%).
Based on these findings, Fursman said that screening for C. auris — which she said is finally getting more traction as a health threat — is an important investment to make, but more funding is needed. She explained that some hospitals and health care facilities may have some room in their budgets for laboratory testing; however, they may not think it necessary.
“If they realize, ‘Hey, it is necessary. It’s something that’s prevalent and emerging in our country,’ then we might invest more into it,” Fursman said.
She added that C. auris is “an unknown until you test for it.”
“You’re never going to know what you don’t know until you go look for it,” Fursman said. “You have to look. You have to be that disease detective and just see what you find.”
For more information
Faith Fursman, BPH, can be reached at faith.fursman@uky.edu.
Sources/Disclosures
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Fursman F, et al. Abstract 171. Presented at: SHEA Spring; April 27-30, 2025; Orlando.
Disclosures:
Fursman reports no relevant financial disclosures.
