Large Candida auris outbreak linked to multi-use thermometers in UK ICU

April 21, 2018, European Society of Clinical Microbiology and Infectious Diseases

Outbreaks of the fungal pathogen Candida auris (C. auris) in healthcare settings, particularly in intensive care units (ICUs), may be linked to multi-use patient equipment, such as thermometers, according to research presented at the 28th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID).

Researchers examined one of the largest outbreaks of the emerging drug-resistant C. auris to date. The outbreak occurred in Oxford University Hospitals' Neurosciences Intensive Care Unit (NICU) in the United Kingdom. In investigating the possible source of the outbreak, researchers found a major source for spreading the fungus was multi-use patient monitoring equipment, such as axillary thermometers, those used to measure temperature in the armpit. These thermometers had been used in 57 of the 66 patients, or 86%, who had been admitted to the NICU before being diagnosed with C. auris. Use of these thermometers was still a strong risk factor for having C. auris after the research team controlled for other factors, such as how long a patient remained in the NICU, how unwell a patient was and their blood tests. Presenting author Dr David Eyre from the Nuffield Department of Medicine at the University of Oxford said: "Despite a bundle of infection control interventions, the outbreak was only controlled following removal of the temperature probes."

Between 2 February 2015 and 31 August 2017, the researchers analysed 70 patients who were either colonised with C. auris, meaning they had the fungus but showed no signs of illness, or infected, meaning they did show symptoms. Sixty-six patients, or 94%, had been admitted to the NICU before being diagnosed. Seven patients developed invasive infections, but none died directly as a result of a C. auris infection. Most patients were colonised for between one to two months. There was no evidence that C. auris was associated with increased rates of death when adjusting for age, sex and the reason the patient had been originally admitted to the ward.

C. auris is an emerging fungal pathogen, which means its presence is growing in the population and it can be responsible for infections in wounds and the bloodstream. The reasons for C. auris spreading are not well understood, but this study offers hope of controlling the fungus' rise. The researchers found that the fungus tested was resistant to common treatments. C. auris is typically resistant to many of the available antifungal drugs, including in Oxford to fluconazole and related drugs, as well as occasionally amphotericin. C. auris was rarely detected in the general ward environment. However, researchers were able to both culture samples from the medical equipment and see it on the surface of using a scanning electron microscope.

They were able to analyse the fungal samples' genetic information and determine that the fungus found on the equipment matched those of the ' samples. It appears that these fungi were able to survive on the hospital equipment despite hygiene standards in place.

"This reinforces the need to carefully investigate the environment, and in particular multi-use patient , in any unexplained healthcare-associated outbreak," Eyre concluded. The team have successfully controlled the .

Explore further: Fungal disease spreads through UK hospitals – here's what you need to know about _Candida auris_

More information: Abstract no: O0172, Epidemiology and successful control of a Candida auris outbreak in a UK intensive care unit driven by multi-use patient monitoring equipment; Interventions in infection control: What works? 13:30 - 15:30, Saturday, 21 April 2018, Hall J

Provided by: European Society of Clinical Microbiology and Infectious Diseases

6 shares

Related Stories

Fungal disease spreads through UK hospitals – here's what you need to know about _Candida auris_

August 18, 2017
At least 20 NHS Trust hospitals have been hit by a drug-resistant fungus, Candida auris. So far, 200 people have been contaminated or infected with the fungus, which can cause potentially deadly complications.

First 13 cases of deadly fungal infection emerge in US

November 4, 2016
Thirteen cases of a sometimes deadly and often drug-resistant fungal infection, Candida auris, have been reported in the United States for the first time, health officials said Friday.

New antifungal provides hope in fight against superbugs

January 12, 2018
Microscopic yeast have been wreaking havoc in hospitals around the world—creeping into catheters, ventilator tubes, and IV lines—and causing deadly invasive infection. One culprit species, Candida auris, is resistant ...

First systematic study of deadly, antibiotic-resistant fungus reported

February 24, 2017
The deadly fungus, Candida auris, which has been found in hospitals, is resistant to entire classes of antimicrobial drugs, limiting treatment options for those infected. First reported in 2009, the fungus has been linked ...

Fungus causing fatal infections in hospitalized patients has unique growth patterns

August 17, 2016
The multidrug-resistant yeast Candida auris, which has caused fatal infections in some hospitalized patients, has at least two different growth patterns and some of its strains are as capable of causing disease as the most ...

Deadly superbug linked to four deaths in the US

November 8, 2016
A deadly new drug-resistant fungus has been linked to the deaths of four hospital patients in the U.S., according to a report released Friday from the Centers for Disease Control and Prevention.

Recommended for you

Breakthrough in designing a better Salmonella vaccine

September 24, 2018
UC Davis researchers announce in the Proceedings of the National Academy of Sciences this week a breakthrough in understanding which cells afford optimal protection against Salmonella infection—a critical step in developing ...

Antifungal agent found to be possible treatment for porphyria

September 24, 2018
A large team of researchers from Spain, France and the U.S. has found that a common antifungal agent might be useful as a treatment for a rare type of porphyria. In their paper published in the journal Science Translational ...

New findings on the muscle disease Laing early-onset distal myopathy

September 24, 2018
New avenues are now being opened toward treatment of Laing distal myopathy, a rare disorder that causes atrophy of the muscles in the feet, hands and elsewhere. In a study published in the journal PNAS, researchers have identified ...

Insulin shows great potential against chronic colitis

September 24, 2018
Diabetes is not the only disease on which insulin has an effect, it appears. In a new study using tests on mice, researchers from the University of Copenhagen, among others, have discovered a new method for treating chronic ...

A new approach to developing a vaccine against vivax malaria

September 21, 2018
A novel study reports an innovative approach for developing a vaccine against Plasmodium vivax, the most prevalent human malaria parasite outside sub-Saharan Africa. The study led by Hernando A. del Portillo and Carmen Fernandez-Becerra, ...

Pre-clinical success for a universal flu vaccine offers hope for third generation approach

September 21, 2018
Researchers from the University of Oxford's Department of Zoology have demonstrated pre-clinical success for a universal flu vaccine in a new paper published in Nature Communications.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.