Major ArticleFirst reported outbreak of the emerging pathogen Candida auris in Canada
Section snippets
Outbreak report
The community hospital affected by the outbreak is a 218-bed facility with a 10 bed ICU, and is part of a regionalized health system with approximately 1,500 acute care beds. Infection prevention and control (IPAC) and diagnostic microbiology services are provided by centralized departments offering distributed services to the health authority. The community hospital has dedicated IPAC practitioners on site, whereas microbiological specimens are forwarded to a central laboratory for processing.
Microbiology & genomics
Yeast isolated from clinical specimens was presumptively identified as C auris using the Bruker Biotyper MALDI-TOF (6903 database). A verification had previously been performed to confirm the accuracy of the platform for detecting C auris.10 All isolates were forwarded to the provincial reference laboratory for confirmatory identification. At the time of the outbreak, there were no commercial selective media options available for screening of C auris. Screening swabs were planted to Brilliance
Discussion
We report the first outbreak of C auris in Canada, which occurred in the ICU of a community hospital in the Greater Vancouver area of British Columbia. Whole-genome sequencing conducted by our federal public health colleagues provided molecular epidemiological evidence linking the cases. It is unclear, however, as to how the C auris strain was introduced into the facility. One patient expired during the outbreak secondary to causes unrelated to C auris; the remaining patients were all
Conclusions
C auris is an emerging threat to healthcare institutions and has been responsible for a number of documented outbreaks. Our experience demonstrates that timely detection of the organism and rapid implementation of infection control measures are capable of limiting transmission; however, there are currently few guidelines to advise on strategies for effective admission screening protocols.17, 18, 19 The CDC recommends screening patients who have had an overnight stay in a healthcare facility
Acknowledgments
We would like to acknowledge the clinical staff, hospital administration, public health officials, and the IPAC team who were involved in direct care of the patients and management of the outbreak. We would also like to thank the staff of the microbiology laboratory for prompt and accurate identifications. Lastly, we would like to acknowledge the help of the colleagues we reached out to for advice and guidance based on their experiences with C auris.
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Conflicts of interest: None to report.
Funding Source: No funding was obtained for the purposes of this outbreak investigation and manuscript preparation.