CDPH Health Advisory: Resurgence of Candida auris in Healthcare Facilities in the Setting of COVID-19 (8-20-20)
Candida auris (C. auris) is a new, emerging fungus that presents a serious global health threat. This novel multi-drug resistant organism (N-MDRO) has caused several healthcare facility outbreaks in the US and abroad. C. auris is a particular health concern because it: can cause severe, antibiotic-resistant infections; is difficult to identify using traditional yeast identification methods; can survive on healthcare setting surfaces for long periods; and can spread easily to patients in healthcare settings.
On May 7, 2019, LAC DPH released an LAHAN describing the first cases of C. auris
in Southern California.
LAC DPH currently considers the following populations to be at high risk for C. auris colonization or infection:
- Roommates of C. auris-positive patients/residents
- Patients/residents who have had an overnight stay in a healthcare facility in a country with transmission or multiple cases of C. auris
- Patients/residents who are colonized with carbapenemase-producing organisms, such as carbapenem-resistant Enterobacterales (CRE).
- Patients/residents on a mechanical ventilator or tracheostomy being admitted from a long-term acute care hospital (LTAC) or skilled nursing facility (SNF) with transmission of C. auris
- Patients/residents who have had an overnight stay in a healthcare facility in a state with transmission C. auris, including New York, New Jersey, and Illinois, in the past 12 months
Patients/residents meeting any of these criteria should be screened for C. auris colonization. LAC DPH can provide additional guidance and free colonization testing swabs if needed.
- Meticulous attention to infection prevention and control, including:
- good hand hygiene (either hand washing with soap and water or hand sanitizing with an alcohol-based hand sanitizer);
- proper selection, use, and disposal of personal protective equipment; and
- appropriate and effective environmental cleaning and disinfection using an agent effective against C. auris.
- Healthcare facilities should review all interim recommendations from the CDC regarding C. auris infection prevention and control and should monitor the CDC site for new information and revisions to current recommendations
- Assistance in determining what types of high-risk patients should be screened for C. auris
- C. auris colonization swabs and/or testing services for certain high-risk patients
- Confirmatory C. auris testing for suspect clinical isolates
- C. auris educational materials
- Sample C. auris protocols, policies, and/or signage
- Infection control consultation to help your facility prepare for and/or contain C. auris
How to Report Candida auris
Both presumptive and confirmed C. auris must be reported to LAC DPH
within 1 working day. Complete the LAC DPH
Candida auris Report Form, attach the final lab result, and fax it
to 888-397-3788. Write "Suspect/confirmed C. auris Case Report" on the
fax cover sheet.
- Providers must report both presumptive and confirmed C.
auris. Presumptive cases include both suspect (i.e.
epidemiologically-linked contacts) as well as presumptive
organisms that are misidentified as C. auris (i.e.
C. haemulonii). To learn what the presumptive C. auris
organisms are based on your facility's lab detection method,
- Laboratories must report confirmed C. auris only.
Laboratories can also set up reporting via ELR.
All facilities must ensure that C. auris status, whether it be
suspect or confirmed, be communicated upon transfer between healthcare
facilities. Facilities can use the
LAC DPH Interfacility Transfer Form, and should make a phone call to the
receiving facility to confirm the information was received. C. auris is
considered to be an emerging pathogen in LAC, so collaboration and communication
will be vital in slowing regional spread.
Candida auris Prevention Project
In 2020, LAC DPH identified a sudden increase in C. auris cases among LAC healthcare facilities. In response, the C. auris Prevention Project was initiated to detect C. auris and strengthen infection control practices as to prevent future spread.
The sites below have collaborated with LAC DPH, CDPH, and CDC in slowing the spread of C. auris in LAC.
- Affinity Healthcare Center
- Barlow Respiratory Hospital
- Beachwood Post-Acute and Rehab
- California Healthcare & Rehabilitation Center
- Colonial Care Center
- Country Oaks Care Center
- Country Villa Sheraton
- Eastland (Alliance) Nursing and Rehabilitation Center
- Gladstone Care and Rehabilitation Center
- Golden Legacy Care Center
- Imperial Crest Healthcare Center
- Kindred Hospital – Baldwin Park
- Kindred Hospital – La Mirada
- Kindred Hospital – Los Angeles
- Kindred Hospital – Paramount
- Kindred Hospital – San Gabriel Valley
- Kindred Hospital – South Bay
- Marina Pointe Healthcare & Subacute
- Monrovia Memorial Hospital
- Mountain View Convalescent
- Park Avenue Healthcare & Wellness Center
- Parkwest Healthcare Center
- Rio Hondo Subacute and Nursing Center
- Sunray Healthcare Center
- Sunset Manor Convalescent Hospital
- The Ellison John Transitional Care Center
- Western Convalescent Hospital
- Windsor Terrace Healthcare Center