A six-month screening campaign contained a Candida auris outbreak at a Seattle hospital without a single patient developing a symptomatic infection, researchers reported Aug. 19 in Clinical Infectious Diseases.
Harborview Medical Center, a 500-bed public hospital and Level I trauma and burn center operated by UW Medicine, identified 29 patients colonized with the drug-resistant fungus over 23 weeks. None became sick, and none required antifungal treatment.
Containment hinged on speed and scale. Infection preventionists screened every patient on admission and again weekly, running 11,639 tests on 5,563 patients. The hospital moved from culture-based testing, which took about seven days, to an in-house PCR (polymerase chain reaction) assay that returned results in about 20 hours — cutting the median turnaround from 82.1 hours to 20.3 hours and letting staff isolate carriers before the fungus could spread.
Half of the colonized patients acquired C. auris in a bed space previously occupied by a positive patient, underscoring how the organism persists on surfaces. In response, Harborview placed carriers in single rooms, required gowns and gloves for staff, cleaned rooms twice with bleach and disinfected them twice with ultraviolet light, then used ATP (adenosine triphosphate) surface testing to confirm the work.
“Transmission was halted only when we ramped up screening to ’11,'” Alexander Greninger, MD, PhD, a professor and division head who co-authored the study, said in a statement.
Whole genome sequencing showed the cases were closely related strains of a single lineage.
In recent years, C. auris has accelerated nationally. U.S. clinical cases more than doubled between 2022 and 2024, reaching 6,197, and the CDC has reported a 34% mortality rate among hospitalizations linked to the fungus. Acute care hospitals account for 76.6% of clinical cases.
Systems are building similar defenses to Harborview Medical Center. Chicago-based Northwestern Medicine and Rush University System for Health have each stood up admission-and-weekly screening programs for high-risk patients.
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