Guidance to Home Care and Hospice Providers on Invasive Infections Caused by the Multidrug-Resistant Yeast Candida auris

Last week, the Department of Health (DOH) issued another guidance document to home care and hospice providers regarding the global emergence of invasive infections caused by the multidrug-resistant yeast Candida auris (C. auris).

In June 2016, the Centers for Disease Control and Prevention (CDC) issued a Clinical Alert for C. auris that highlighted four areas:

Reports from health care facilities outside the U.S. indicate that C. auris is causing health care-associated infections with high mortality and that C. auris has a high potential to cause outbreaks in health care facilities.
Infections caused by C. auris often do not respond to commonly used antifungal drugs, making them difficult to treat.
Patients who have long stays in intensive care units or who have central venous catheters or other indwelling devices, and who have previously received antibiotics or antifungal medications, appear to be at highest risk of infection.
Specialized laboratory methods are needed to accurately identify C. auris.

As of now, DOH has issued three Health Advisories, which can all be reviewed in this latest guidance.

In this document, the CDC and DOH outline their recommendations for home care and hospice staff. The highlights include the following:

Infection control precautions in home care and hospices for persons colonized or infected with C. auris are similar to precautions taken in health care facilities.
Strict adherence to hand hygiene practices by staff is essential.
If a patient is colonized or infected with a multidrug-resistant organism (MDRO) such as C. auris, their immediate environment can become contaminated.
Although MDROs such as C. auris are not known to be a risk to providers who practice good infection prevention and control measures, they might be transmitted to other home care and hospice patients through inanimate objects or hands.
Reusable medical equipment and devices (e.g. stethoscopes and blood pressure cuffs) should remain in the home.
If practical, schedule home visits for patients with an MDRO such as C. auris as the last visit of the day.
As an emerging pathogen, C. auris is a reportable condition.
If a patient is transferred to a health care facility, notify the DOH regional epidemiologist.

The guidance document also reviews patient/family education, links to additional resources, and DOH Epidemiology and Infection Control Program regional and central office contact information.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871