How two California hospitals prevented the spread of a deadly fungal infection during the pandemic

Arlington, Va., June 29, 20,21 - In the midst the COVID-19 pandemic in the United States, two hospitals in Southern California took drastic measures to stop the spread a deadly fungus. They will present their proactive solutions at today's 48th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).Scripps Memorial in La Jolla, and UCLA Health Los Angeles, responded separately. They isolated suspected or confirmed patients and worked closely with public and private health departments, information technology, and lab teams at their facilities to implement aggressive measures to stop Candida auris spreading."The fact that these teams recognized the threat and were able mobilize so quickly while also being on high alert for COVID, is remarkable," stated Ann Marie Pettis (BSN, RN), CIC, FAPIC. "Their case studies show how critical it is for hospitals, long-term care facilities, and clinics to have sufficient infection preventionists and the resources to train and monitor staff so that they can prevent harm from multiple fronts.C. auris, a type of fungus, can cause severe and sometimes fatal infections. It is resistant to most antifungal medications. C. auris can live on the skin of patients and can persist on surfaces for up to a month. This allows it to spread easily among them. C. auris can be killed by most hospital disinfectants, which makes it difficult to eliminate from healthcare environments. It can also be misidentified in laboratory tests.In March 2020, during the initial COVID-19 patient influx, Elizabeth A. Jefferson, BS and PhD, CIC of Scripps Memorial was informed that her facility had been the first to receive C. auris.Initially, the patient was isolated and flagged because he had received medical treatment abroad. Laboratory tests later confirmed that C. auris had been present in the wound. For 47 days the patient was kept in isolation. The team used aggressive cleaning measures including disinfectant against C. auris, and ultraviolet light to clean all patient rooms.Jefferson stated that it was important to educate staff. "Staff needed to disinfect and clean the room at least twice per day. They also had to clean all shared equipment. Candida auris can be very difficult to eradicate if it sets up shop in your facility."To ensure that there was no transmission, the team teamed up with public health agencies, including the CDC's Antibiotic Resistance Lab Network.Jefferson stated that hospitals must be vigilant for C. auris. Without specialized laboratory equipment, you won't be able to tell if a patient has been colonized or infected.The fungal pathogen, which has infected almost 1,800 people in 15 states and District of Columbia, was not transmitted to patients. It was first discovered in the U.S. in 2015.UCLA Health was prepared when C. auris began to rise in Southern California in the summer 2020. They were aware of the destruction C. auris caused in other states and had created a multi-level notification system to prevent transmission.The infection preventionists worked together with the laboratory's electronic medical records team (EMR) to ensure that the EMR system was properly set up to screen all patients for COVID and Candida auris upon entry. Patients at high risk were identified and sent notifications to infection prevention, laboratory, nursing, and environmental services. To enable communication between the receiving facilities and the health department about the patient's C.auris status, the system placed holds on patient charts before discharge or transfer.The system sent reminders to follow strict cleaning protocols. These included environmental surface testing after final cleaning to make sure that there was no organism in the patient's bedroom."Having an in-house laboratory that could test C.auris, and working with the EMR team on a series of screening steps into our EMR made it a failsafe method to monitor and track any C.auris cases at our facility. This was a good way to prevent cross contamination in healthcare environments," said Urvashi Parti MPH, an infection preventionist at UCLA Health.Engaging senior leaders to understand the importance of monitoring both C.auris as COVID simultaneously was another key factor in achieving success."We had the support of senior leaders, who made sure that we had the resources to support the early identification of C. auris in the COVID-19 pandemic," stated Shaunte Walton MS, CIC Health System Director of Clinical Epidemiology & Infection Prevention, UCLA Health.###About APICAPIC's Annual Conference was held June 28-30. It featured more than 100 educational sessions by experts from around the world. The conference was attended by researchers, epidemiologists and educators as well as administrators and medical technologists. They provided strategies that can immediately be used to improve healthcare safety and prevent future infections. Use the hashtag #APIC2021 to join the conversation on social media.Through the prevention of infections, the Association for Professionals in Infection Control and Epidemiology is making the world safer. Nearly 16,000 APIC members create and direct infection prevention programs that save lives, improve healthcare facilities' bottom lines, and increase productivity. APIC's mission is accomplished through advocacy, data standardization, patient safety, education and implementation science. Visit us at