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Should all hospitalised patients colonised with Candida auris be considered for isolation?

Summary

Candida auris is a dangerous yeast found in hospitals that can spread quickly between patients and is very difficult to treat. Healthcare experts in the Netherlands have decided that all hospital patients carrying this fungus should be isolated in single rooms, even if their strain is susceptible to antifungal drugs, because the infection can develop resistance quickly and cause serious illness. This strict isolation approach helps prevent outbreaks and protects vulnerable patients from developing life-threatening blood infections.

Background

Candida auris is an emerging pathogenic yeast causing nosocomial infections with high mortality, particularly in vulnerable populations. It is classified as a critical fungal pathogen by the WHO and poses significant challenges due to rapid resistance development, difficult detection, and challenging decolonization strategies.

Objective

To discuss whether all hospitalized patients colonized with Candida auris should be isolated regardless of antifungal susceptibility patterns. The paper examines the reasoning behind the Dutch national MDRO guideline decision to isolate all C. auris colonized patients equally.

Results

The Dutch MDRO guideline recommends isolation of all hospitalized patients colonized with C. auris in single-bed rooms with anteroom and adequate ventilation, regardless of antifungal susceptibility. Key findings include evidence of rapid resistance development during treatment and pan-susceptible isolates causing multicenter outbreaks.

Conclusion

Isolating all C. auris colonized patients, independent of susceptibility testing, is justified due to rapid resistance development potential, outbreak propensity, difficult decolonization, high mortality rates in invasive infections, and significant healthcare costs. Comprehensive infection prevention and control measures are essential to prevent outbreaks and endemic transmission in healthcare facilities.
  • Published in:Eurosurveillance,
  • Study Type:Editorial/Expert Opinion,
  • Source: PMID: 39512165
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