Candida auris Colonization After Discharge to a Community Setting: New York City, 2017-2019

Open Forum Infect Dis. 2020 Dec 15;8(1):ofaa620. doi: 10.1093/ofid/ofaa620. eCollection 2021 Jan.

Abstract

Background: Patients colonized with multidrug-resistant Candida auris and discharged to a community setting can subsequently seek care in a different healthcare facility and might be a source of nosocomial transmission of C auris.

Methods: We designed a case management pilot program for a cohort of New York City residents who had a history of positive C auris culture identified during clinical or screening activities in healthcare settings and discharged to a community setting during 2017-2019. Approximately every 3 months, case managers coordinated C auris colonization assessments, which included swabs of groin, axilla, and body sites yielding C auris previously. Patients eligible to become serially negative were those with ≥2 C auris colonization assessments after initial C auris identification. Clinical characteristics of serially negative and positive patients were compared.

Results: The cohort included 75 patients. Overall, 45 patients were eligible to become serially negative and had 552 person-months of follow-up. Of these 45 patients, 28 patients were serially negative (62%; rate 5.1/100 person-months), 8 were serially positive, and 9 could not be classified as either. There were no clinical characteristics that were significantly different between serially negative and positive patients. The median time from initial C auris identification to being serially negative at assessments was 8.6 months (interquartile range, 5.7-10.8 months).

Conclusions: A majority of patients, assessed at least twice after C auris identification, no longer had C auris detectable on serial colonization assessments.

Keywords: Candida auris; New York City; colonization; community setting.