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

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: see text] [Figure: see text] 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