Reviewed by Jen Cihlar, DO, Vanderbilt University Medical Center
Candida auris screening across 3 LTACHs in Orange County, CA started as a response to an initial case in 2/2019 but the authors noted trends in C. auris colonization emerged over 5 epidemiologically distinct of phases of the COVID-19 pandemic between 3/14/19-7/18/22. C. auris surveillance methods across the 3 LTACHs escalated from initial point prevalence studies 1 to 2 times monthly to universal admission screening beginning 11/2020. The authors calculated probability of C. auris skin colonization over 45 days and plotted cumulative incidence function. Early COVID after “shelter-in-place order” and the first winter wave (periods 2,3) had the highest probability of developing C. auris colonization after an average length of stay 30 days (19.7%, 22.5%) compared to periods 1 (9.2%), 4 (9.6%) or 5 (10.9%), during delta and omicron phases though there was only statistical difference between period 3 and the others given small sample size of period 2 despite similar cumulative incidence trend curves. This reflects how lack critical operational challenges like PPE shortage, breakdown in other infection prevention standards, possible prioritization of cohorting COVID-19 patients led to rise of colonization during periods 2-3. With median C. auris prevalence rates finding sustained higher community prevalence even throughout periods 4 & 5, though reduction cumulative incidence rates during those period supports within-facility transmission could be curbed with re-initiation of adherence to infection prevention practices.
Reference:
Dratch AH, Le M, Zahn M. Increased Incidence of Candida auris Colonization in Early COVID-19 Pandemic, Orange County, California, USA. Emerging Infectious Diseases. 2025;31(9):1747-1754. doi:10.3201/eid3109.241342.