Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study

被引：13

作者：

Sathyapalan, Dipu Thareparambil ^{[1
,2
]}

Antony, Remya ^{[3
]}

Nampoothiri, Vrinda ^{[3
]}

Kumar, Anil ^{[4
]}

Shashindran, Nandita ^{[4
]}

James, Jini ^{[3
]}

Thomas, Jisha ^{[3
]}

Prasanna, Preetha ^{[1
,2
]}

Sudhir, Akkulath Sangita ^{[3
]}

Philip, Jeslyn Mary ^{[3
]}

Edathadathil, Fabia ^{[3
]}

Prabhu, Binny ^{[5
]}

Singh, Sanjeev ^{[3
]}

Moni, Merlin ^{[1
,2
]}

机构：

[1] Amrita Inst Med Sci, Dept Gen Med, Kochi, Kerala, India

[2] Amrita Inst Med Sci, Div Infect Dis, Kochi, Kerala, India

[3] Amrita Inst Med Sci, Dept Infect Control & Epidemiol, Kochi, Kerala, India

[4] Amrita Inst Med Sci, Dept Microbiol, Kochi, Kerala, India

[5] Epsom & St Heliers NHS Trust, Dept Geriatr & Gen Med, Epsom, Surrey, England

来源：

BMC INFECTIOUS DISEASES | 2021年 / 21卷 / 01期

关键词：

Infection prevention and control; Candida auris; Outbreak; Bundle; Implementation; Containment; Hand hygiene; Index case; Multidisciplinary; Low-and middle; income country; CLONAL STRAIN; INFECTIONS; RESISTANCE;

D O I：

10.1186/s12879-021-06131-6

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background Candida auris infections are an emerging global threat with poor clinical outcome, high mortality rate, high transmission rate and outbreak potential. The objective of this work is to describe a multidisciplinary approach towards the investigation and containment of a Candida auris outbreak and the preventive measures adopted in a resource limited setting. Methods This outbreak investigational study was conducted at a 1300-bedded tertiary care academic hospital in South India. The study included 15 adult inpatients with laboratory confirmed Candida auris isolates. The outbreak cluster was identified in adult patients admitted from September 2017 to 2019. The system response consisted of a critical alert system for laboratory confirmed Candida auris infection and multidisciplinary 'Candida auris care team' for patient management. The team implemented stringent Infection Prevention and Control (IPC) measures including patient cohorting, standardized therapy and decolonization, staff training, prospective surveillance and introduction of Candida auris specific care bundle. Results Two outbreak clusters were identified; first cluster occurring between October and November 2017 and the second cluster in May 2018. The cohorts consisted of 7 and 8 Candida auris positive patients in the first and second waves of the outbreak respectively with a total survival rate of 93% (14/15). Deployment of containment measures led to gradual decline in the incidence of adult Candida auris positive cases and prevented further cluster formation. Conclusions The sustained implementation of guideline and evidence-based IPC measures and training of healthcare workers for improving awareness on systematically following standardized protocols of Candida auris related IPC practices successfully contained Candida auris outbreaks at our hospital. This demonstrates the feasibility of establishing a multidisciplinary model and bundling of practices for preventing Candida auris outbreaks in a Low- and Middle-income country.

引用

页数：10