TESTING for Candida auris on patient admission helped to identify more cases, and reduced the number of hospital-onset cases, according to a new study. Researchers used PCR testing to screen for C. auris and establish which patients needed to be admitted into private rooms under special precautions, in order to limit the number of infected patients once in hospital.
The authors conducted the study across an integrated health system. Patients were assessed based on risk factors for carrying C. auris. PCR tests were sent out to a reference laboratory pre-intervention, and post-intervention was conducted in-house. Interrupted time series analysis was used to assess the changes in the incident rates of C. auris present on admission and hospital-onset C. auris. Overall, 4,778 PCR tests screening for C. auris colonisation on 4,270 patients were performed.
Results showed 159 cases of C. auris present on admission, and an increase in incidence rate in the post-intervention period (incidence rate ratio: 2.57; 95% confidence interval [CI]: 1.16–5.69) compared with the pre-intervention period (1.94 cases for every 10,000 patient admissions). A total of 75 cases of hospital onset C. auris were also reported, with a monthly decline in the incidence rate in the post-intervention period (95% CI: 0.80–0.99). However, there was a 14% monthly increase in hospital-onset C. auris pre-intervention (95% CI: 1.05–1.24). The median stay for patients screened for C. auris was 8 days, with contact precautions remaining until PCR results became available. Through the use of in-house testing, the turnaround time from admission to results was reduced to 2 days, compared to 11 days pre-intervention. In-house testing also had an economic impact, with the total of estimated isolation and testing cost savings ranging from 772,513.10–3,730,480.26 USD.
Conclusions drawn from the study indicated that performing in-house testing for C. auris significantly reduced the rate of hospital-onset cases. It also allowed for more efficient and more cost-effective use of infection control.
