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Proactive Screening Program Detects First Outbreak of C. auris Fungus in Washington State

On January 10, 2024, Public Health – Seattle & King County was notified about a patient who had be tested positive for Candida auris (C. auris), a form of fungus identified at Kindred Hospital Seattle. C. auris can cause severe infections and is often resistant to antifungal treatment. Through the proactive Partners for Patient Safety Program, all patients admitted to Kindred Hospital are screened for C. auris, ensuring early detection of the fungus. This helps control its spread as patients often do not show symptoms but can still transmit it to others.

Two more C. auris cases were found on January 22, and a fourth was identified on January 26. These patients had initially tested negative for C. auris on admission. This outbreak represented the first known occurrence of this fungus in Washington State. Strategies implemented to control this spread include isolating affected patients to reduce the transmission risk and using specific disinfectants effective against C. auris. Facilities having treated previous patients from Kindred or patients testing positive for C. auris are also alerted. As with most multi-drug-resistant organisms, identifying the initial source of infection can be challenging and may remain unknown in this case. However, early case detection increases the chances to manage and control any further spread.

Previously, on July 13, 2023, Public Health – Seattle & King County reported the first believed local case of C. auris. Identified in King County, the patient was a resident of Pierce County who had been moved from St. Joseph’s Hospital to Kindred-First Hill, where they tested positive for C. auris. The patient was under proper C. auris precautions throughout their stay. The proactive Partners for Patient Safety Program strategy, which anticipates the detection of C. auris in Washington State, helped in this early identification, demonstrating the program’s effectiveness.

The threat of antibiotic resistance, wherein bacterial infections become immune to standard antibiotics, also extends to certain types of fungi. These fungi can colonize the body and potentially lead to infections similar to bacteria but can develop resistance to standard treatments. When these organisms become immune to various antibiotics, they are termed multi-drug resistant organisms (MDROs). A new program in King County aims to identify these organisms early to reduce their spread in healthcare settings.

Findings suggest that approximately 5% to 10% of patients colonized with C. auris will eventually develop serious invasive infections, with over 45% dying within the first 30 days. Therefore, efforts are concentrated on managing the risk and spread of C. auris, especially within high-risk healthcare facilities.

The new Partners for Patient Safety program is proactive in countering the C. auris threat. Through widespread screening of symptom-less patients, it aims to limit potential infections and transmission. Kindred Hospital, the first in the state to initiate such widespread screening, is leading the way in these efforts.

If the fungus is identified in patients, thorough cleaning and monitoring of the healthcare facility are conducted to ensure C. auris is not inadvertently transmitted via patients, staff, or equipment. The outcome of these preventive measures will shape future guidance for similar acute care settings across the nation.


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