1444. Candida auris Outbreak in a COVID-19 Hospital: Detection and Containment

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Abstract Background Candida auris has become an important nosocomial infection in ICU patients. The difficulty in isolating and detecting this pathogen, its inherent multidrug resistance, and rapid transmission make it a menace to public health. The present work details the first C. auris outbreak in Mexico and containment techniques used in a Tertiary Care Center that underwent restructuring due to COVID-19. Methods We performed a single-center, retrospective, descriptive study from June 2020 to February 2022 at Hospital San Jose TecSalud, Monterrey, including hospitalized COVID-19 patients with detection of Candida auris by MALDI-TOF. After identifying the first cases, the exposed patients were screened twice weekly by skin (armpit/groin) swab culture. Those who tested positive were classified as colonization. Patients with clinical signs of infection were tested from sterile sites (blood/urine), and if the culture came back positive they were classified as cases. Finally, we described the interventions for containment. Results During the study period, 4,025 patients were hospitalized due to COVID-19; 971 were critically ill patients admitted to the ICU. 160 patients tested positive for Candida auris, 131 colonizations, and 29 cases (Figure 1). Of the total, 83% were male, mean age ± SD = 56.96 ± 13.29. The most common sites of infection in the cases group were urinary tract infections (55.17%) and bloodstream infections (44.81%; from this, 23% were catheter-associated). The first case was detected on June 4th, 2020, in July 2020, we transitioned to a single patient-per-nurse model and implemented disinfection validation via ATP bioluminescence. Also, to control the increase in cases, by the end of 2020, we standardized chlorine cleaning and de-escalated PPE, and implemented hydrogen peroxide vapor and reinforcement of hand-washing techniques (Figure 2).Figure 1.Patient’s Demographics.Figure 2.Outbreak. Conclusion In the setting of the transition of Hospital San Jose into a COVID-19 Hospital in response to the high volume of patients, and the emergence of C. auris at the ICU; early detection and screening of the exposed population, multi-disciplinary coordination between healthcare teams, and the rapid installation of interventions were crucial for the containment and termination of the outbreak. Disclosures All Authors: No reported disclosures

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