Characteristics and Mitigation Measures of Candida auris Infection: Descriptive Analysis from a Quaternary Care Hospital in Saudi Arabia, 2021-2022.

OBJECTIVE: To analyze the characteristics of C. auris cases, and to describe the interventions applied for improving the diagnosis and controlling the transmission. METHOD: Medical records of C. auris cases reported between January 2021 until June 2022 at King Saud Medical City (KSMC), Riyadh, Kingdom of Saudi Arabia have been reviewed. We analyzed the demographic and clinical characteristics of the cases to illustrate the possible contributing factors with C. auris infection. A multidisciplinary committee has been formulated to investigate the potential source of the outbreak among clusters of cases in the intensive care units (ICU). A bundle of mitigation measures has been applied which was successful to contain the outbreak. RESULTS: During the study period, a total of 129 cases of C. auris were identified, their mean age is 47 ± 22.3 SD, and 72.1% are males. 57% of cases were colonized, all of them were identified through active screening. A number of comorbidities were present including 27.9% were having hypertension, 27.1% with diabetes, 22.5% with COVID-19 and 20.2% with respiratory diseases. The average length of stay before reported positive was 36.23 days. 78.3% of those patients were in the critical care unit, 73.6% with vascular catheter, 88% with urinary catheters and 66.7% with mechanical ventilation. The vast majority of patients were using multiple antibiotics (86%). As per the univariate logistic model, risk factors significantly associated with mortality were (Age, Trauma RTA, ICU, Vascular Access, Foley Catheters, Mechanical Ventilation, Tracheostomy and Endotracheal Tubes) with p values (0.0038, 0.0159, 0.0108, 0.0122, 0.0071, <.0001, 0.0148 and 0.0107), respectively. Multivariate logistic regression showed that having a Foley Catheter was the only statistically significant factor associated with mortality. CONCLUSION: This retrospective analysis  highlights the main characteristics associated with C. auris-infected patients. In addition, it highlights the effectiveness of the bundle of mitigation strategies applied to limit the spread of C. auris in healthcare facilities.

Characteristics of healthcare workers with COVID-19: A retrospective descriptive study in a quaternary care center in Riyadh, Saudi Arabia.

BACKGROUND: The aim of this study was to describe the epidemiological and clinical presentation of Healthcare Workers (HCWs) affected by COVID-19. METHODS: A cross-sectional retrospective study was conducted at King Saud Medical City (KSMC), Saudi Arabia (KSA). All KSMC employees who acquired COVID-19 between March 22nd to July 15th, 2020 have been included. Their data has been anonymously analyzed. FINDINGS: During the study period, among the 12000 HCWs working at KSMC, 9.75% tested positive for COVID-19. The source of HCWs infections was mainly community acquired (85%) which included incidences of transmission in hospital dormitories. Transmission among coworkers was the main source of hospital acquired incidences. Direct patient care was reported in 99.8% of study subjects among the high-risk areas, compared to 3.4% in low-risk areas (p-value <0.001), 12-h shifts were more common in the medium and high-risk areas, and at least one symptom was reported by 93.1% of HCWs in high-risk areas compared to 81.6% in low-risk areas (p-value <0.001). CONCLUSION: In KSA, for HCWs, reducing lapses in compliance with masking in non-patient care areas should be considered. In KSA the role that hospital dormitories play in the community transmission of COVID-19 among HCWs need further studies.