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First Candida auris Outbreak Experience in a Tertiary-Care General Hospital in Qatar, 2019

Published online by Cambridge University Press:  02 November 2020

Feah Visan
Affiliation:
Hamad Medical Corporation, Al Wakra Hospital
Naser Al Ansari
Affiliation:
Al Wakra Hospital
Walid Al Wali
Affiliation:
Al Wakra Hospital
Almunzer Zakaria
Affiliation:
Al Wakra Hospital
Omar Al Hasanat
Affiliation:
Al Wakra Hospital
Jenalyn Castro
Affiliation:
Al Wakra Hospital
Ghada Hudaib
Affiliation:
Al Wakra Hospital
Ubaid Ummer
Affiliation:
Al Wakra Hospital
Jameela Al Ajmi
Affiliation:
Corporate Infection Prevention and Control, Hamad Medical Corporation
Mildred Asuncion
Affiliation:
Al Wakra Hospital
Adila Shaukat
Affiliation:
Hamad medical Corporation
Manal Hamed
Affiliation:
Al Wakra Hospital
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Abstract

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Background:Candida auris is an invasive, multidrug-resistant pathogen that can cause outbreaks in hospitals. The mode of transmission is through contaminated hospital items such as fomites and staff interventions. The outbreak of Candida auris affecting 13 patients at the medical intensive care unit (MICU) and medical inpatient unit, either in the form of infection or colonization, is the first documented C. auris outbreak in the Qatar. Methods: The first case was identified in November 2018 in a patient colonized in the respiratory tract. Candida auris biweekly tests were conducted. The second to fourth cases were confirmed in the MICU admitted in the same room (room 2). The fifth case was identified incidentally and was not part of the screening in another ward (6 North Medical Inpatient Unit), and 4 weeks later, Candida auris was isolated from the urine and throat of a patient on this ward. The realization that case 5 was an index case changed the direction of the outbreak investigation, and expanded screening was started among the medical inpatients. When the IPC team identified cases 6–11 and 13, all had possible epidemiological links with case 5. Results: Our root-cause analysis suggests that the index case came from another general hospital. However, because no screening protocol has been established for Candida auris, interventions have not been in place to effectively prevent and control this organism. A strong collaborative outbreak team worked to end this outbreak using the following evidence-based IPC interventions: (1) patient screening and decolonization; (2) environmental screening; (3) enhanced environmental disinfection using peracetic acid wipes, 1% chlorine, and hydrogen peroxide vapor disinfection; (4) prophylactic contact precautions; (5) enhanced hand hygiene with bare below elbows protocol; and (6) a no white gown policy. Conclusions: The outbreak of Candida auris was declared to have nbeen terminated on August 22, 2019. Despite the long period involved in this outbreak, we succeeded in ending it through the concerted efforts of a multidisciplinary team utilizing the latest scientific evidence.

Funding: None

Disclosures: None

Type
Poster Presentations
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.