Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates

Background: Candida auris screening is one of the crucial components of infection prevention and control measures to curb the spread of C. auris. However, previous research has yielded various results on the effectiveness of C. auris screening according to region, type of healthcare facility, and pa...

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Main Authors: Sungsoo Park, Heesuk Kim, Kilchae Hwang, Duckjin Hong, Estephanie Padua, Eunjung Kim, Hyeyoung Oh
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Journal of Infection and Public Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S1876034125000085
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author Sungsoo Park
Heesuk Kim
Kilchae Hwang
Duckjin Hong
Estephanie Padua
Eunjung Kim
Hyeyoung Oh
author_facet Sungsoo Park
Heesuk Kim
Kilchae Hwang
Duckjin Hong
Estephanie Padua
Eunjung Kim
Hyeyoung Oh
author_sort Sungsoo Park
collection DOAJ
description Background: Candida auris screening is one of the crucial components of infection prevention and control measures to curb the spread of C. auris. However, previous research has yielded various results on the effectiveness of C. auris screening according to region, type of healthcare facility, and patient group in the various levels of endemicity. We aimed to assess the clinical effectiveness of routine C. auris screening upon admission to the intensive care unit (ICU). Methods: This retrospective study involved 3356 ICU patients during pre-screening (N = 1658, June 2020 to November 2021) and post-screening period (N = 1698, June 2022 to November 2023). Swabs for C. auris screening were taken from axilla and groin, then cultured, and identified using either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 YST identification card. We compared the positivity rates of C. auris during the pre- and post-screening period. Results: Of the 1698 patients who underwent C. auris screening, only 4 (0.2 %) tested positive. The positivity rates before and after the introduction of the screening program were 2.92 cases per 1000 patient days (36/12333) and 2.36 (21/8909), respectively, without significant difference (P = 0.435). Interrupted times series analysis showed no immediate (P = 0.775) or sustained (P = 0.484) effects from the screening program. Subgroup analysis of patients in the medical ICU showed similar results. Conclusions: Universal C. auris screening upon ICU admission identified a small number of cases. Instead, targeted screening and regular point prevalence surveys, along with other infection prevention and control measures may be employed. Further studies in various settings with diverse testing strategies are needed to establish the most effective approach for C. auris screening.
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spelling doaj-art-17dfa61488cd42ce80f7f52cd01b0adb2025-08-20T03:00:34ZengElsevierJournal of Infection and Public Health1876-03412025-03-0118310265910.1016/j.jiph.2025.102659Screening of Candida auris upon admission to an intensive care unit in the United Arab EmiratesSungsoo Park0Heesuk Kim1Kilchae Hwang2Duckjin Hong3Estephanie Padua4Eunjung Kim5Hyeyoung Oh6Division of Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates; Department of Pulmonology, Seoul National University Hospital, Seoul, Republic of KoreaEnvironmental Safety Healthcare Provider Team, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab EmiratesDepartment of Laboratory Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates; Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Republic of Korea; PureLab, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab EmiratesDepartment of Laboratory Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates; Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Republic of Korea; PureLab, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab EmiratesInfection Prevention and Control Team, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab EmiratesDivision of Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates; Infection Prevention and Control Team, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab EmiratesDivision of Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates; Environmental Safety Healthcare Provider Team, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates; Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Corresponding author at: Division of Medicine, Sheikh Khalifa Specialty Hospital, Al Shohadaa Road, PO Box 6365, Ras Al Khaimah, United Arab Emirates.Background: Candida auris screening is one of the crucial components of infection prevention and control measures to curb the spread of C. auris. However, previous research has yielded various results on the effectiveness of C. auris screening according to region, type of healthcare facility, and patient group in the various levels of endemicity. We aimed to assess the clinical effectiveness of routine C. auris screening upon admission to the intensive care unit (ICU). Methods: This retrospective study involved 3356 ICU patients during pre-screening (N = 1658, June 2020 to November 2021) and post-screening period (N = 1698, June 2022 to November 2023). Swabs for C. auris screening were taken from axilla and groin, then cultured, and identified using either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 YST identification card. We compared the positivity rates of C. auris during the pre- and post-screening period. Results: Of the 1698 patients who underwent C. auris screening, only 4 (0.2 %) tested positive. The positivity rates before and after the introduction of the screening program were 2.92 cases per 1000 patient days (36/12333) and 2.36 (21/8909), respectively, without significant difference (P = 0.435). Interrupted times series analysis showed no immediate (P = 0.775) or sustained (P = 0.484) effects from the screening program. Subgroup analysis of patients in the medical ICU showed similar results. Conclusions: Universal C. auris screening upon ICU admission identified a small number of cases. Instead, targeted screening and regular point prevalence surveys, along with other infection prevention and control measures may be employed. Further studies in various settings with diverse testing strategies are needed to establish the most effective approach for C. auris screening.http://www.sciencedirect.com/science/article/pii/S1876034125000085Candida aurisIntensive care unitsPrevalenceInfection control
spellingShingle Sungsoo Park
Heesuk Kim
Kilchae Hwang
Duckjin Hong
Estephanie Padua
Eunjung Kim
Hyeyoung Oh
Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates
Journal of Infection and Public Health
Candida auris
Intensive care units
Prevalence
Infection control
title Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates
title_full Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates
title_fullStr Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates
title_full_unstemmed Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates
title_short Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates
title_sort screening of candida auris upon admission to an intensive care unit in the united arab emirates
topic Candida auris
Intensive care units
Prevalence
Infection control
url http://www.sciencedirect.com/science/article/pii/S1876034125000085
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