Research and analysis

HPR volume 11 issue 28: news (11 August)

Updated 15 December 2017

1. Candida auris in the United Kingdom: updated guidance published

PHE has published new guidance on the management of Candida auris, including an updated version of guidance for laboratories, healthcare providers and healthcare professionals first published in June 2016 [1].

The updated guidance for laboratories and healthcare professionals is published alongside new guidance, intended primarily for nursing homes, that can be adapted for residential homes and other such community care settings; this is aimed at facilitating the discharge or transfer of hospital patients into such community settings [2].

A new patient information leaflet is also available for healthcare professionals in hospitals and community care facilities to download and either circulate directly to colonised individuals and their families, or adapt for other purposes [3].

As at the beginning of July 2017, 20 separate NHS Trusts and independent hospitals in the United Kingdom had detected over 200 patients colonised or infected with C. auris. Three hospitals have seen large nosocomial outbreaks; as of Monday 14 August, all 3 hospitals had declared their outbreaks over. Over 35 other hospitals have had patients known to be colonised with C. auris transferred to them.

Most detections within the UK have been from colonised patients, picked up through enhanced surveillance activities in the three most affected hospitals. Approximately one quarter of detections have been clinical infections, including 27 patients who developed blood stream infections. There has been no attributable mortality to C. auris within the UK, in contrast to the high case fatality reported in the literature.

A pilot survey of patients being admitted to ICU was launched in July 2017, with screening of all patients on ward entry to critical care settings in 5 English hospitals serving diverse populations to determine the background rate of colonisation. The results of this will help inform future surveillance strategies.

PHE’s National Infection Service continues to work closely with microbiologists and clinicians in hospitals to investigate potential risk factors for colonisation and clinical infection, and the Biosafety Investigation Unit at PHE Porton Down is investigating the fungicidal activity of a variety of disinfectants and antiseptics.

This is an abridged version of a fuller report of the same title published on the webpage, Candida Auris Emergence in the United Kingdom.

1.1 References

1. PHE (August 2017). Guidance for the laboratory investigation, management and infection prevention and control for cases of Candida auris.

2. PHE (August 2017). Candida auris: infection control in community care settings.

3. PHE (August 2017). Candida auris: a guide for patients and visitors.

2. Infection reports in this issue of HPR

The following reports are published in this issue of HPR. The links below are to the relevant webpage collections:

• Common animal associated infections quarterly report (England and Wales): second quarter 2017
• Laboratory reports of hepatitis A infections in England and Wales, 2016
• Salmonella and shigella infections from faecal specimens (England and Wales): laboratory reports, June-July 2017
• Common GI infections (England and Wales): laboratory reports, weeks 27-30/2017
• Suspected and laboratory-confirmed reported norovirus outbreaks in hospitals: outbreaks occurring in weeks 27-30, 2017
• Less common gastrointestinal infections, England: Laboratory reports weeks, weeks 1-30, 2017