Health Update: Ongoing transmission of Candida auris in Washington healthcare facilities

This is a Health Update from the Washington Department of Health (DOH) regarding ongoing healthcare-associated transmission of Candida auris (C. auris); this serves as an update to our previous Health Advisory from January 2024, after local transmission of C. auris was first identified.

Current Situation in Washington

Public Health Partners should be aware that Public Health – Seattle & King County has recently identified two healthcare facilities in King County with ongoing C. auris transmission: Harborview Medical Center and Kindred Hospital. Due to the increased number of facilities with ongoing transmission, DOH is alerting local public health jurisdictions (LHJs) and Tribal Health Partners to be aware of this increase in cases.

To facilitate notification to healthcare facilities, the DOH Multi-Drug Resistant Organism (MDRO) Program has also drafted a Provider Alert for LHJs and Tribal Health Partners to distribute.

Actions Requested

All LHJs and Tribal Health Partners should be aware that there is ongoing healthcare-associated transmission of C. auris in Washington in at least two facilities; jurisdictions should be aware that there may be undetected cases in other facilities.

  • DOH recommends C. auris admission screening and contact precautions (CP) in private room until screened negative for patients admitted from the following facilities:
    • Harborview Medical Center: admitted with an overnight stay since April 1, 2024; if available, see CareEverywhere flags with information about C. auris exposure and screening recommendations.
    • Kindred Hospital: admitted in the prior 6 months.

Using CP for these patients is the most cautious approach. If CP are not feasible, the next most cautious action would be to use Enhanced Barrier Precautions for both the screened patient and any roommate until screening is negative.

  • Jurisdictions should encourage facilities to consider implementing admission screening for C. auris and carbapenemase-producing organisms (CPO) in patients with risk factors.
  • Jurisdictions should be aware that C. auris screening is available through the Washington State Public Health Laboratories (PHL); testing may also be available through some commercial laboratories.
    • LHJs and Tribal Health Partners should contact the DOH Multi-Drug Resistant Organism (MDRO) program MDRO-AR@doh.wa.gov to coordinate screening testing at PHL.
    • In addition to PHL, facilities in your jurisdiction may also have access to C. auris screening tests via commercial laboratories, including (but not limited to): LabCorp, Quest, Mayo Clinic, and ARUP. Facilities should check with their clinical laboratory contacts for the latest information about test availability.
  • Encourage clinical laboratories to increase speciation of Candida from non-sterile sites, prioritizing urine cultures over wound and respiratory sources.
  • Report C. auris cases or outbreaks to MDRO-AR@doh.wa.gov

To facilitate notification to healthcare facilities, the DOH Multi-Drug Resistant Organism (MDRO) Program has also drafted a Provider Alert for LHJs and Tribal Health Partners to distribute.

Background

C. auris is an emerging, often multi-drug resistant yeast, that was first identified in the US in 2009. The first locally acquired case of C. auris in Washington was reported in 2023, and the first outbreak was reported in January 2024. It can cause difficult to control outbreaks in high acuity facilities, especially among patients with invasive devices and wounds. C. auris may colonize patients long term and also cause invasive infections. Both colonized and infected persons can transmit the organism in healthcare settings. C. auris is not a risk to the general public, nor to most hospitalized patients.

DOH Resources

Contact

For questions, or to report cases, please contact your local health jurisdiction.