Expanded protocols enhance early detection in high-risk patients and help prevent outbreaks of Candida auris in hospitals.
Researchers from Mount Sinai have improved screening protocols in hospitals for Candida auris, a fungal pathogen that is often resistant to treatment and is regarded by the Centers for Disease Control and Prevention as a pressing global health concern. The new guidelines, detailed in an analysis published in the American Journal of Infection Control on October 31, aim to facilitate the early identification of this dangerous fungus in high-risk patients and to avert hospital outbreaks.
C. auris first emerged in New York City in 2016 and can lead to severe infections in the bloodstream, wounds, and ears. This fungus can impact various body systems and particularly poses serious risks to individuals with weakened immune systems. It can also easily spread in healthcare environments, as it survives on contaminated surfaces or medical equipment for weeks.
Experts at Mount Sinai have introduced broader hospital admission screening protocols for identifying C. auris. This includes screening all newly admitted patients who had lived in a nursing home in the month before their hospital stay, regardless of other risk factors. This change moves away from previous methods that varied between healthcare facilities and mainly targeted patients showing more apparent risk factors, such as those with tracheostomies or on ventilators.
“Our findings signify a notable step forward in infection control and patient safety, especially for transfers from skilled nursing facilities,” stated Waleed Javaid, MD, MBA, MS, a Professor of Medicine and Director of Infection Prevention and Control at Mount Sinai Downtown. “Addressing Candida auris necessitates careful vigilance, swift diagnosis, suitable treatment, and rigorous infection control measures to curb its spread within healthcare settings.”
In a retrospective analysis, researchers screened all 591 patients admitted to Mount Sinai Brooklyn from nursing homes between January 2022 and September 2023 for C. auris. They applied these enhanced screening protocols for one year and compared the findings to the nine months prior to implementing the changes. The researchers identified 14 cases, or 2.4 percent, of this group tested positive for C. auris. Among these, nine were categorized as high risk, while five were low risk at the time of screening. Thanks to the new protocol, eight cases were discovered that would have otherwise gone undetected under the former guidelines, enabling the Mount Sinai team to quickly implement necessary isolation, contact precautions, and disinfection measures to prevent further spread.
“Our study underscores the necessity for hospitals to embrace expanded screening protocols to strengthen infection control strategies,” stated Scott Lorin, MD, MBA, President of Mount Sinai Brooklyn and Associate Professor of Medicine at Icahn Mount Sinai. “Wider screening not only facilitates early detection but also supports targeted precautions, reducing the chances of outbreaks in hospitals. Implementing proactive protocols, informed by community prevalence rates, is a vital approach to managing the proliferation of this emerging global health threat.”
