Dix L M L, Notermans D W, Schneeberger C, van Dijk K
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Medical Microbiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
J Hosp Infect. 2025 Feb;156:106-112. doi: 10.1016/j.jhin.2024.12.004. Epub 2024 Dec 19.
Candida auris can cause nosocomial outbreaks and provides challenges concerning diagnosis, treatment, eradication and infection prevention. There are no Dutch standards or guidelines for C. auris, and current hospital practices are unknown. Therefore, we assessed whether Dutch hospitals are prepared for C. auris introduction.
An online questionnaire concerning screening, diagnostics, infection prevention and outbreaks was distributed amongst medical microbiologists and infection prevention practitioners in spring 2024.
Fifty-two questionnaires were processed comprising 58 hospitals. Most participants (60%) did not screen for C. auris carriership and 51% did not have a protocol describing screening procedures. Healthcare workers were rarely screened. Screening sites and number of swabs varied. All respondents would place a patient with C. auris in isolation, 71% had a protocol describing isolation measures. Most hospitals took extra cleaning precautions after finding C. auris. None of the hospitals ever had a C. auris-outbreak, 29% had an outbreak protocol. Procedures to cease isolation were present in 31%, but 10% never declare a patient C. auris-free. A diagnostic protocol (available in 53%) was primarily based on culture, but the execution differed. Molecular diagnostics were rarely used (12%). The majority did not screen nor did they have a protocol describing multi-drug-resistant candida outbreak coordination.
Screening, diagnostics, infection prevention, control and outbreak management of C. auris vary amongst Dutch hospitals, and most are not fully prepared for C. auris. As inadequate preparation for C. auris is an international concern, guidance documents could aid in fulfilling this need.
耳念珠菌可引发医院感染暴发，并在诊断、治疗、根除及感染预防方面带来挑战。荷兰尚无针对耳念珠菌的标准或指南，目前医院的实际做法也尚不清楚。因此，我们评估了荷兰医院是否为耳念珠菌的引入做好了准备。
2024年春季，向医学微生物学家和感染预防从业人员发放了一份关于筛查、诊断、感染预防和暴发情况的在线问卷。
共处理了52份问卷，涉及58家医院。大多数参与者（60%）未对耳念珠菌携带情况进行筛查，51%没有描述筛查程序的方案。医护人员很少接受筛查。筛查部位和拭子数量各不相同。所有受访者都会将耳念珠菌感染患者隔离，71%有描述隔离措施的方案。大多数医院在发现耳念珠菌后采取了额外的清洁预防措施。没有一家医院发生过耳念珠菌暴发，29%有暴发预案。31%的医院有解除隔离的程序，但10%的医院从未宣布患者耳念珠菌清除。诊断方案（53%的医院有）主要基于培养，但执行情况有所不同。很少使用分子诊断（12%）。大多数医院既不进行筛查，也没有描述耐多药念珠菌暴发协调的方案。
荷兰医院在耳念珠菌的筛查、诊断、感染预防、控制和暴发管理方面存在差异，大多数医院对耳念珠菌的准备并不充分。由于对耳念珠菌准备不足是一个国际关注的问题，指导文件可能有助于满足这一需求。
