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C. auris and neighborhood socioeconomic vulnerability in the state of Maryland from 2019 to 2022

Published online by Cambridge University Press:  30 July 2024

L. Leigh Smith Open the ORCID record for L. Leigh Smith [Opens in a new window] ,
Jason Falvey Open the ORCID record for Jason Falvey [Opens in a new window] ,
Brittany Grace Open the ORCID record for Brittany Grace [Opens in a new window] ,
Elisabeth Vaeth ,
Jamie Rubin ,
Rebecca Perlmutter ,
David Blythe ,
Daryl Hawkins ,
Martha Mbuthia  and
Mary-Claire Roghmann Open the ORCID record for Mary-Claire Roghmann [Opens in a new window]
...Show all authors
L. Leigh Smith*
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
Jason Falvey
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
Brittany Grace
Affiliation:
Maryland Department of Health; Baltimore, MD, USA
Elisabeth Vaeth
Affiliation:
Maryland Department of Health; Baltimore, MD, USA
Jamie Rubin
Affiliation:
Maryland Department of Health; Baltimore, MD, USA
Rebecca Perlmutter
Affiliation:
Maryland Department of Health; Baltimore, MD, USA
David Blythe
Affiliation:
Maryland Department of Health; Baltimore, MD, USA
Daryl Hawkins
Affiliation:
Maryland Department of Health; Baltimore, MD, USA
Martha Mbuthia
Affiliation:
Maryland Department of Health; Baltimore, MD, USA
Mary-Claire Roghmann
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
Clare Rock
Affiliation:
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine; Baltimore, MD, USA
Surbhi Leekha
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
*
Corresponding author: L. Leigh Smith; Email: llsmith@som.umaryland.edu
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Abstract

Background:

Candida auris is an emerging fungal pathogen increasingly recognized as a cause of healthcare-associated infections including outbreaks.

Methods:

We performed a mixed-methods study to characterize the emergence of C. auris in the state of Maryland from 2019 to 2022, with a focus on socioeconomic vulnerability and infection prevention opportunities. We describe all case-patients of C. auris among Maryland residents from June 2019 to December 2021 detected by Maryland Department of Health. We compared neighborhood socioeconomic characteristics of skilled nursing facilities (SNFs) with and without C. auris transmission outbreaks using both the social vulnerability index (SVI) and the area deprivation index (ADI). The SVI and the ADI were obtained at the state level, with an SVI ≥ 75th percentile or an ADI ≥ 80th percentile considered severely disadvantaged. We summarized infection control assessments at SNFs with outbreaks using a qualitative analysis.

Results:

A total of 140 individuals tested positive for C. auris in the study period in Maryland; 46 (33%) had a positive clinical culture. Sixty (43%) were associated with a SNF, 37 (26%) were ventilated, and 87 (62%) had a documented wound. Separate facility-level neighborhood analysis showed SNFs with likely C. auris transmission were disproportionately located in neighborhoods in the top quartile of deprivation by the SVI, characterized by low socioeconomic status and high proportion of racial/ethnic minorities. Multiple infection control deficiencies were noted at these SNFs.

Conclusion:

Neighborhood socioeconomic vulnerability may contribute to the emergence and transmission of C. auris in a community.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , First View , pp. 1 - 7
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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