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

IF 3 4区医学 Q2 INFECTIOUS DISEASES Infection Control and Hospital Epidemiology Pub Date : 2024-07-30 DOI:10.1017/ice.2024.98

L Leigh Smith, Jason Falvey, Brittany Grace, Elisabeth Vaeth, Jamie Rubin, Rebecca Perlmutter, David Blythe, Daryl Hawkins, Martha Mbuthia, Mary-Claire Roghmann, Clare Rock, Surbhi Leekha

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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.

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从 2019 年到 2022 年，马里兰州的 C. auris 和社区社会经济脆弱性。

背景：念珠菌是一种新出现的真菌病原体，越来越多地被认为是导致医疗相关感染（包括疾病爆发）的原因之一：我们开展了一项混合方法研究，以描述2019年至2022年马里兰州出现的念珠菌病，重点关注社会经济脆弱性和感染预防机会。我们描述了马里兰州卫生部在 2019 年 6 月至 2021 年 12 月期间检测到的马里兰州居民中的所有 C. auris 病例患者。我们使用社会脆弱性指数（SVI）和地区贫困指数（ADI）比较了有和没有爆发法氏囊病传播的专业护理机构（SNFs）附近的社会经济特征。SVI 和 ADI 在州一级获得，SVI ≥ 第 75 百分位数或 ADI ≥ 第 80 百分位数被视为严重贫困。我们通过定性分析总结了发生疫情的 SNF 的感染控制评估：在研究期间，马里兰州共有 140 人检测出阴沟肠杆菌阳性；46 人（33%）临床培养呈阳性。60人（43%）与SNF有关，37人（26%）接受过通风治疗，87人（62%）有伤口记录。单独的设施级社区分析表明，可能存在法氏囊病传播的 SNF 多位于 SVI 排名前四分位的贫困社区，这些社区的特点是社会经济地位低、少数种族/族裔比例高。在这些住院医疗设施中，存在多种感染控制缺陷：结论：邻里社会经济的脆弱性可能会导致阴沟肠杆菌在社区的出现和传播。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection Control and Hospital Epidemiology 医学-传染病学

CiteScore

6.40

自引率

6.70%

发文量

289

审稿时长

3-8 weeks

期刊介绍： Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.