With an increasing number of C. auris cases identified across southern California, local health departments including OCHCA will no longer be tracking patients discharged from local LTACHs and sub-acute units (SAUs) for coordination of C. auris screenings. It should be understood that there is an existing underlying risk of C. auris exposure in these settings. In accordance with CDPH guidance, OCHCA recommends that facilities conduct screening of patients transferring from any county LTACH or SAU, and place them on appropriate empiric Precautions while awaiting results.
 
OCHCA continues to work with OC LTACHs and SAUs to conduct point prevalence surveys of C. auris on an ongoing basis, and also responds to known exposure events. However, Public Health does not have capacity to provide screening resources for all discharges from LTACHs and SAUs. There are several private labs that can provide PCR testing for C. auris.
 
Length of patients’ stays should be considered when deciding whether to screen them. A negative screening result can remove a patient from empiric precautions, but it may take several days to get the result.

Precaution Recommendations According to Facility Type

Communication between healthcare facilities:
 
Communicating the MDRO status of patients between healthcare facilities continues to be an issue in Orange County. We have witnessed multiple lapses in communication regarding transfer of C. auris colonized patients. All MDROs should be clearly communicated between facilities, especially when patients are colonized with unusual organisms like Candida auris.

  • Inter-facility transfer forms or equivalent communication should be used any time patients colonized or infected with MDROs are transferred between healthcare facilities. Your facility may choose to use OCHCA's Infection Control Transfer Form, which is available online here.

  • It is recommended that if your facility is transferring a patient who is known to be colonized or infected with Candida auris that your staff make a call to the receiving facility to make sure they are aware of the patient’s status.

General Recommendations
In all settings:
  • Practice good hand hygiene. (note: alcohol based hand sanitizers are effective against C. auris)
  • Periodic audits of both healthcare and EVS staff are recommended by OCHCA, and there are tools to help you complete these audits available upon request.
  • Cleaning agents effective against C. auris include those on List P (registered with the EPA with claims against C. auris), bleach, or agents on List K.

For more information about C. auris, please see the following links:

For other questions regarding Candida auris, please email HAITeam@ochca.com.


Thanks,

Matt Zahn, MD
Medical Director, Communicable Disease Control
Orange County Health Care Agency