Investigation and successful control of a outbreak at a tertiary health care facility in Kenya.

OBJECTIVES

This study aimed to conduct an epidemiological and genomic investigation of a hospital outbreak of , and implement measures for its control.

METHODS

We collected demographic and clinical data from medical records of patients with from January 2017 to June 2019 after identifying increased cases in April 2019. Point-prevalence surveys for colonisation were conducted in the critical care units (CCU). Antifungal susceptibility testing and genomic sequencing of isolates were performed. A bundle of infection prevention and control measures was instituted.

RESULTS

Thirty-two patients with were identified. All patients had a history of CCU admission. A total of 283 screening swabs were obtained and 57 isolates of identified. Antifungal susceptibility testing was performed on 48 isolates. All but two isolates were resistant to fluconazole; one isolate was also resistant to amphotericin B. Forty-one of 46 isolate genomes were clonally related and formed a distinct genetic cluster in Clade III. colonisation reduced from 42% in June 2019 to 1% in August 2019, and no new hospital-acquired colonisation was identified in the subsequent 9 months.

CONCLUSIONS

We identified a new genetic subcluster of Clade III We also show that strict implementation of infection prevention measures can lead to substantial reductions in transmission.