Network Analysis of Candida auris Transmission in a Hospital Setting: A Retrospective Cohort Study in Georgia

Abstract

Introduction
This study investigates a Candida auris outbreak across two interconnected hospitals in Georgia April-July 2023, assessing direct and indirect unit overlaps as transmission routes.

Methods
A retrospective cohort study design was employed, using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight mass spectrometry to identify clinical and screening cases of C. auris per Council of State and Territorial Epidemiologists definitions. Point prevalence surveys for C. auris colonization were conducted. The Georgia Department of Public Health and hospital infection prevention teams collected data on patient locations and risk factors. Patient and staff overlap, and networked movement patterns were visualized using R and Excel, with patients numbered 1-10 based on admission dates.

Results

  • Clinical Cases:
    • Patient 2, admitted to Facility B without contact precautions on 4/20, developed positive C. auris cultures on 5/18.
    • Patient 3, admitted to Facility A on 4/24 and transferred to Facility B on 4/29, showed infection on 5/24, having extensive intrafacility movement.
    • Both cases involved invasive procedures and device use.
  • Screening Cases:
    • Patient 1 was admitted with precautions at Facility A on 4/13. Patients 4–7 screened positive on 6/5 and Patients 8–10 on 7/10, all with complex histories and invasive device use. Patients 4–10 were admitted to Facility B.
  • Direct and Indirect Overlap:
    • Direct: Patient 1 with Patient 3 in Facility A; Patient 3 with Patients 6 and 7 in Facility B’s Medical ICU. Patient 2 in Facility B’s Pulmonary ICU with Patients 4 and 5; Patient 5 with Patient 10 in MICU.
    • Indirect: 3 Patients in Facility A’s ICU and 4 patients in Facility B. Patient 8 had overlap with 5 Patients.

Discussion
Point prevalence surveys and admission screening are essential for detecting silent transmission and C. auris importation. Findings emphasize the need for infection prevention monitoring to reduce transmission risks.

Keywords

Candida auris, Infection Control, Point Prevalence Survey, Transmission Dynamics, Antimicrobial Resistance, Healthcare-Associated Infection, Multi-drug Resistant Organism

Conflict of Interest Form

I understand that if my abstract is selected and I agree to present that I must register for the conference and pay the registration fee to attend at least the day of the conference that I present. This includes all Learning Methods except invited Key Note Speakers.

This document is currently not available here.

Share

COinS
 

Network Analysis of Candida auris Transmission in a Hospital Setting: A Retrospective Cohort Study in Georgia

Introduction
This study investigates a Candida auris outbreak across two interconnected hospitals in Georgia April-July 2023, assessing direct and indirect unit overlaps as transmission routes.

Methods
A retrospective cohort study design was employed, using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight mass spectrometry to identify clinical and screening cases of C. auris per Council of State and Territorial Epidemiologists definitions. Point prevalence surveys for C. auris colonization were conducted. The Georgia Department of Public Health and hospital infection prevention teams collected data on patient locations and risk factors. Patient and staff overlap, and networked movement patterns were visualized using R and Excel, with patients numbered 1-10 based on admission dates.

Results

  • Clinical Cases:
    • Patient 2, admitted to Facility B without contact precautions on 4/20, developed positive C. auris cultures on 5/18.
    • Patient 3, admitted to Facility A on 4/24 and transferred to Facility B on 4/29, showed infection on 5/24, having extensive intrafacility movement.
    • Both cases involved invasive procedures and device use.
  • Screening Cases:
    • Patient 1 was admitted with precautions at Facility A on 4/13. Patients 4–7 screened positive on 6/5 and Patients 8–10 on 7/10, all with complex histories and invasive device use. Patients 4–10 were admitted to Facility B.
  • Direct and Indirect Overlap:
    • Direct: Patient 1 with Patient 3 in Facility A; Patient 3 with Patients 6 and 7 in Facility B’s Medical ICU. Patient 2 in Facility B’s Pulmonary ICU with Patients 4 and 5; Patient 5 with Patient 10 in MICU.
    • Indirect: 3 Patients in Facility A’s ICU and 4 patients in Facility B. Patient 8 had overlap with 5 Patients.

Discussion
Point prevalence surveys and admission screening are essential for detecting silent transmission and C. auris importation. Findings emphasize the need for infection prevention monitoring to reduce transmission risks.