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纽约市一家医院对耳念珠菌扩大入院筛查方案的分析。

Analysis of an expanded admission screening protocol for Candida auris at a New York City hospital.

作者信息

Cheng Aaron, Brody Karen, Ehni Jordan, Gallate Zachary, Lorin Scott, Camins Bernard, Javaid Waleed

机构信息

Department of Infection Control, Mount Sinai Beth Israel and Mount Sinai Brooklyn, New York, NY.

Icahn School of Medicine at Mount Sinai, New York, NY.

出版信息

Am J Infect Control. 2025 Jan;53(1):70-74. doi: 10.1016/j.ajic.2024.08.027. Epub 2024 Nov 1.

Abstract

BACKGROUND

Candida auris (C auris) is an emerging global infectious disease threat, and screening practices for identification of C auris are inconsistent across healthcare facilities. This study describes the utility of expanding a C auris admission screening protocol at an acute care hospital to screen all patients presenting from any skilled nursing facility.

METHODS

A retrospective review identified all patients screened on admission for C auris from January 2022 through September 2023. Patients were identified for risk potential, and those deemed high risk were placed on transmission-based precautions while awaiting culture results.

RESULTS

Of the 591 patients screened, 14 cases were identified (2.4%). Nine cases presented with tracheostomies or were ventilator-dependent and classified as high risk. Five cases were considered low risk at the time of screening. Eight of these newly identified cases would not be screened under the prior criteria.

DISCUSSION

This study's findings support prior studies that patients with tracheostomies or were ventilator-dependent have greater risk for C auris colonization. Adopting an expanded admission screening program has allowed the hospital to detect more cases earlier to prevent nosocomial transmissions.

CONCLUSIONS

Healthcare facilities should consider initiating or expanding admission screening programs for C auris based on community prevalence rates of C auris.

摘要

背景

耳念珠菌是一种新出现的全球传染病威胁,各医疗机构对耳念珠菌的筛查方法并不一致。本研究描述了在一家急症医院扩大耳念珠菌入院筛查方案以筛查所有来自任何专业护理机构的患者的效用。

方法

一项回顾性研究确定了2022年1月至2023年9月期间所有入院时接受耳念珠菌筛查的患者。确定患者的潜在风险,那些被认为高风险的患者在等待培养结果期间采取基于传播的预防措施。

结果

在591名接受筛查的患者中,发现14例(2.4%)。9例患者有气管造口术或依赖呼吸机,被归类为高风险。5例在筛查时被认为是低风险。这些新发现的病例中有8例在之前的标准下不会被筛查。

讨论

本研究结果支持先前的研究,即有气管造口术或依赖呼吸机的患者耳念珠菌定植风险更高。采用扩大的入院筛查计划使医院能够更早地发现更多病例,以预防医院内传播。

结论

医疗机构应根据耳念珠菌的社区流行率考虑启动或扩大耳念珠菌入院筛查计划。

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