P-1057. Candidozyma (Candida) auris in the United States: Insights from the SHEA Research Network

Abstract Background We queried the Society for Healthcare Epidemiology (SHEA) Research Network (SRN) regarding C. auris prevention practices in the United States.Table 1Characteristics of Participating SHEA Research Network Facilities.Figure 1:Geographic distribution of SHEA institutions by region.Location and number of participating institutions are shown by geographic region. Pink diamonds indicate a region where survey participants reported a multidrug resistant Candidozyma auris isolate (defined as C. auris isolates with resistance to 3 or more antifungal classes). Methods A REDCap survey was distributed by email to SRN institutions in the United States. We assessed institution characteristics, prevention practices, and perceived barriers to C. auris prevention. Results Responses were received from 53/96 (55%) facilities (Table), with 34/53 (64%) reporting experience with ≥1 C. auris case; 32/34 facilities (94%) reported at least one C. auris outbreak and 5/34 facilities (14%) had identified a C. auris isolate with resistance to ≥3 antifungal classes (Figure). C. auris screening was reported in 24/53 (45%) of facilities, including admission screening in 13/24 (54%) facilities and response-based screening in 10/24 (42%). Screening body sites included the axillae (24/24, 100%), groin (23/24, 96%), and anterior nares (7/24, 39%). The most common testing method was polymerase chain reaction-based (17/24, 71%). Prevention practices included patient isolation (45/53, 84%) and enhanced disinfection of shared patient equipment (24/53, 45%) and the healthcare environment (36/53, 68%). The most commonly identified barriers to control of C. auris included lack of communication between healthcare facilities (32/53, 60%), lack of microbiologic/diagnostic services (24/53, 45%), and lack of infection control at outside facilities prior to patient transfer (20/53, 37%). The highest priority tools to support C. auris prevention were development of effective decolonization regimens (28/53, 53%), standardized protocols for screening (22/53, 42%), and improved communication at time of patient transfer between facilities (20/53, 37%). Conclusion Multiple SRN facilities reported firsthand experience with C. auris, with a high rate of outbreaks at participating sites. Surveillance was performed in approximately half (45%) of participating facilities, with both admission and response-based screening commonly reported. As C. auris becomes increasingly prevalent, additional standardized guidance may help align heterogenous prevention practices. Disclosures All Authors: No reported disclosures