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Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study

BACKGROUND: Candida auris infections are an emerging global threat with poor clinical outcome, high mortality rate, high transmission rate and outbreak potential. The objective of this work is to describe a multidisciplinary approach towards the investigation and containment of a Candida auris outbr...

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Autores principales: Sathyapalan, Dipu Thareparambil, Antony, Remya, Nampoothiri, Vrinda, Kumar, Anil, Shashindran, Nandita, James, Jini, Thomas, Jisha, Prasanna, Preetha, Sudhir, Akkulath Sangita, Philip, Jeslyn Mary, Edathadathil, Fabia, Prabhu, Binny, Singh, Sanjeev, Moni, Merlin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101254/
https://www.ncbi.nlm.nih.gov/pubmed/33957894
http://dx.doi.org/10.1186/s12879-021-06131-6
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author Sathyapalan, Dipu Thareparambil
Antony, Remya
Nampoothiri, Vrinda
Kumar, Anil
Shashindran, Nandita
James, Jini
Thomas, Jisha
Prasanna, Preetha
Sudhir, Akkulath Sangita
Philip, Jeslyn Mary
Edathadathil, Fabia
Prabhu, Binny
Singh, Sanjeev
Moni, Merlin
author_facet Sathyapalan, Dipu Thareparambil
Antony, Remya
Nampoothiri, Vrinda
Kumar, Anil
Shashindran, Nandita
James, Jini
Thomas, Jisha
Prasanna, Preetha
Sudhir, Akkulath Sangita
Philip, Jeslyn Mary
Edathadathil, Fabia
Prabhu, Binny
Singh, Sanjeev
Moni, Merlin
author_sort Sathyapalan, Dipu Thareparambil
collection PubMed
description BACKGROUND: Candida auris infections are an emerging global threat with poor clinical outcome, high mortality rate, high transmission rate and outbreak potential. The objective of this work is to describe a multidisciplinary approach towards the investigation and containment of a Candida auris outbreak and the preventive measures adopted in a resource limited setting. METHODS: This outbreak investigational study was conducted at a 1300-bedded tertiary care academic hospital in South India. The study included 15 adult inpatients with laboratory confirmed Candida auris isolates. The outbreak cluster was identified in adult patients admitted from September 2017 to 2019. The system response consisted of a critical alert system for laboratory confirmed Candida auris infection and multidisciplinary ‘Candida auris care team’ for patient management. The team implemented stringent Infection Prevention and Control (IPC) measures including patient cohorting, standardized therapy and decolonization, staff training, prospective surveillance and introduction of Candida auris specific care bundle. RESULTS: Two outbreak clusters were identified; first cluster occurring between October and November 2017 and the second cluster in May 2018. The cohorts consisted of 7 and 8 Candida auris positive patients in the first and second waves of the outbreak respectively with a total survival rate of 93% (14/15). Deployment of containment measures led to gradual decline in the incidence of adult Candida auris positive cases and prevented further cluster formation. CONCLUSIONS: The sustained implementation of guideline and evidence-based IPC measures and training of healthcare workers for improving awareness on systematically following standardized protocols of Candida auris related IPC practices successfully contained Candida auris outbreaks at our hospital. This demonstrates the feasibility of establishing a multidisciplinary model and bundling of practices for preventing Candida auris outbreaks in a Low- and Middle-income country. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06131-6.
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spelling pubmed-81012542021-05-06 Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study Sathyapalan, Dipu Thareparambil Antony, Remya Nampoothiri, Vrinda Kumar, Anil Shashindran, Nandita James, Jini Thomas, Jisha Prasanna, Preetha Sudhir, Akkulath Sangita Philip, Jeslyn Mary Edathadathil, Fabia Prabhu, Binny Singh, Sanjeev Moni, Merlin BMC Infect Dis Research BACKGROUND: Candida auris infections are an emerging global threat with poor clinical outcome, high mortality rate, high transmission rate and outbreak potential. The objective of this work is to describe a multidisciplinary approach towards the investigation and containment of a Candida auris outbreak and the preventive measures adopted in a resource limited setting. METHODS: This outbreak investigational study was conducted at a 1300-bedded tertiary care academic hospital in South India. The study included 15 adult inpatients with laboratory confirmed Candida auris isolates. The outbreak cluster was identified in adult patients admitted from September 2017 to 2019. The system response consisted of a critical alert system for laboratory confirmed Candida auris infection and multidisciplinary ‘Candida auris care team’ for patient management. The team implemented stringent Infection Prevention and Control (IPC) measures including patient cohorting, standardized therapy and decolonization, staff training, prospective surveillance and introduction of Candida auris specific care bundle. RESULTS: Two outbreak clusters were identified; first cluster occurring between October and November 2017 and the second cluster in May 2018. The cohorts consisted of 7 and 8 Candida auris positive patients in the first and second waves of the outbreak respectively with a total survival rate of 93% (14/15). Deployment of containment measures led to gradual decline in the incidence of adult Candida auris positive cases and prevented further cluster formation. CONCLUSIONS: The sustained implementation of guideline and evidence-based IPC measures and training of healthcare workers for improving awareness on systematically following standardized protocols of Candida auris related IPC practices successfully contained Candida auris outbreaks at our hospital. This demonstrates the feasibility of establishing a multidisciplinary model and bundling of practices for preventing Candida auris outbreaks in a Low- and Middle-income country. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06131-6. BioMed Central 2021-05-06 /pmc/articles/PMC8101254/ /pubmed/33957894 http://dx.doi.org/10.1186/s12879-021-06131-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Sathyapalan, Dipu Thareparambil
Antony, Remya
Nampoothiri, Vrinda
Kumar, Anil
Shashindran, Nandita
James, Jini
Thomas, Jisha
Prasanna, Preetha
Sudhir, Akkulath Sangita
Philip, Jeslyn Mary
Edathadathil, Fabia
Prabhu, Binny
Singh, Sanjeev
Moni, Merlin
Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study
title Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study
title_full Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study
title_fullStr Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study
title_full_unstemmed Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study
title_short Evaluating the measures taken to contain a Candida auris outbreak in a tertiary care hospital in South India: an outbreak investigational study
title_sort evaluating the measures taken to contain a candida auris outbreak in a tertiary care hospital in south india: an outbreak investigational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8101254/
https://www.ncbi.nlm.nih.gov/pubmed/33957894
http://dx.doi.org/10.1186/s12879-021-06131-6
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