Patients colonized or infected with
) continue to be identified in Orange County.
In communities experiencing
outbreaks in this country, colonization rates have consistently been highest in residents of long term acute care hospitals (LTACs) and skilled nursing facilities that provide ventilator care (vSNFs). Accordingly, point prevalence surveys have been completed in all LTACs and vSNFs in Orange County. Over 60 colonized patients have been identified by point prevalence surveys in these facilities. These cases are the first identified in Southern California.
OCHCA is working with all facilities where
-colonized patients have been identified to assure that receiving facilities are informed of the situation when patients are transferred. While colonization rates are highest in LTACs and vSNFs,
transmission can occur in a variety of healthcare settings. Appropriate infection control measures should be taken by healthcare providers in all settings.
- Healthcare facilities should institute empiric Standard and Contact Precautions for:
- All patients admitted from all LTACs in Orange County.
- All patients admitted from vSNFs where C. auris-colonized patients have been identified.
- Admission screening for C. auris should be performed by receiving facilities for all patients from the above facilities who may be admitted for a prolonged period (one week or longer).
- Admission screening for C. auris should include a composite swab of the axilla and groin as well as a swab of the nares. The CDC recommends inclusion of nares swabbing to optimize testing yield.
- Patients who have been previously screened at a facility with C. auris-colonized patients should still have admission screening performed at the accepting facility.
- Culture testing for C. auris colonization is available through the Centers for Disease Control and Prevention (CDC) and takes 7-21 days to result.
- Hospitals accepting patients from facilities where C. auris-colonized patients have been identified should contact OCHCA at 714-834-8180 to arrange for receipt of screening swabs and to coordinate their transfer to a public health laboratory for testing.
- Facility-to-facility communication is critical when transferring a patient who is suspected or confirmed to be colonized or infected with C. auris. Any receiving facility should be made aware of the patient’s status.
- Hospitals that frequently share patients with Orange County LTACs and/or with vSNFs where C. auris-colonized patients have been identified are currently recommended to perform species identification of all clinical Candida isolates, regardless of specimen source. OCHCA has contacted the affected facilities regarding this recommendation. Enhanced Candida speciation will help assure identification of C. auris. No additional surveillance or infection control measures are recommended for these hospitals at this point.