Proactive infection control measures to prevent nosocomial transmission of Candida auris in Hong Kong

With the emergence of multi-drug-resistant Candida auris in 2009 in Japan, nosocomial transmission and outbreaks have been reported in many parts of the world [ [1] Desoubeaux G. Coste A.T. Imbert C. Hennequin C. Overview about Candida auris: what's up 12 years after its first description?. J Mycol Med. 2022; 32101248 Crossref Scopus (10) Google Scholar ]. In Hong Kong, C. auris colonization was first identified from a patient with a history of travel to Switzerland in June 2019, and nosocomial outbreaks of C. auris have been reported in local hospitals since July 2020 [ [2] Centre for Health ProtectionAlert on the rise in Candida auris colonisation in Hong Kong. Kowloon: Centre for Health Protection, 2020https://www.chp.gov.hk/files/pdf/lti_c_auris_20201015_eng.pdf Google Scholar ]. At Queen Mary Hospital, a university-affiliated teaching hospital of 1700 beds, we adopt proactive infection control measures to prevent importation of C. auris. Admission screening is performed for patients if they have been hospitalized outside Hong Kong in the preceding 12 months, and also for patients who have been transferred from local hospitals with ongoing C. auris outbreaks. Pooled swabs of a patient's nasal, axilla and groin are collected for testing using polymerase chain reaction (PCR) and fungal culture. Fungal isolates are identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and subjected to whole-genome sequencing (WGS) (see online supplementary material). Patients colonized or infected with C. auris are isolated in single rooms with strict contact precautions. Infection control nurses (ICNs) supervise environmental decontamination and perform contact tracing according to risk assessment.