Evaluation of Active Surveillance Testing for Candidozyma (Candida) auris and Impact on Infection Control Behaviors in an Acute Healthcare System.

OBJECTIVE

To evaluate the impact of active surveillance testing (AST) for Candidozyma auris on healthcare system epidemiologic trends and infection prevention and control (IPC) behaviors.

DESIGN

Explanatory sequential mixed methods study using retrospective electronic medical record review, hand hygiene observations, and healthcare personnel focus groups.

SETTING AND PATIENTS: Five acute care hospitals within a suburban healthcare system. Chart reviews included 3,688 patients who underwent AST for C. auris or had positive clinical cultures for C. auris from 2020-2023.

METHODS

Incidence and prevalence were calculated by year and location. Logistic regression examined associations with C. auris events. Observations and focus groups explored barriers and facilitators to IPC behaviors.

RESULTS

AST volume increased from 66 tests in 2020 to 1,619 in 2023, while positivity decreased from 7.58% to 2.47%. Concurrent increases in community-onset and hospital-onset prevalence were observed over time. Focus groups identified barriers including fatigue and accountability, and facilitators including role modeling and supply accessibility.

CONCLUSIONS

AST facilitated early identification of colonized or infected patients and supported systemic surveillance of C. auris, while behavioral assessment identified opportunities to strengthen adherence to core IPC practices. These findings demonstrate the value of integrating epidemiologic and behavioral evaluation when assessing IPC programs.