Identification of Candida auris in a foreign repatriated patient to Ontario, Canada and infection control strategies to prevent transmission

Background: Candida auris (C. auris) is an emerging fungus which presents a global health threat with increased morbidity and mortality in hospitalized patients. Upon identification of our first case of C. auris on admission from a foreign hospital, we set out to implement infection prevention and control (IPAC) measures to prevent transmission. Methods: We conducted a prospective surveillance of C. auris in a community teaching hospital from April 2019 to November 2020. We also implemented protocols to prevent C. auris infection such as staff education and training; establishing policy/procedures for screening and testing of patients at risk and/or colonized with C. auris; validation of microbiology methodology, cleaning and disinfection protocols to prevent equipment and environmental contamination, and patient and family information. Results: Following this prospective surveillance program, a positive case of C. auris was identified from a high-risk patient admitted to the hospital. After identification of the case of C. auris, over 600 unit mates (patients on the same unit) were screened, and multiple environmental specimens were tested for C. auris, but no additional case was detected or evidence of hospital-acquired transmission over the 19-month hospitalization of the case. Conclusion: Multidisciplinary approach, extra resources and senior management support are necessary to prevent and control transmission of C. auris within the healthcare setting.