Preparedness for Candida auris in Canadian Nosocomial Infection Surveillance Program (CNISP) hospitals, 2024

OBJECTIVE: To assess preparedness for Candida auris in Canadian hospitals. DESIGN: Cross-sectional survey. SETTING: Canadian Nosocomial Infection Surveillance Program (CNISP) hospitals. METHODS: In June 2024, surveys were e-mailed to the infection prevention and control departments of 109 CNISP hospitals and their 33 microbiology laboratories. The surveys assessed policies for patient screening/management and laboratory processes supporting C. auris transmission prevention. Results were compared to a similar 2018 survey. RESULTS: All 109 hospitals and 32/33 laboratories responded. Most hospitals had policies for admission screening (80%, 87/109) and policies/defined plans for post-exposure screening (95%, 104/109). Policy presence increased from 18% to 73% in 56 hospitals completing both 2018 and 2024 surveys (P < 0.001). Among hospitals with admission screening policies, 69% (60/87) screened for recent out-of-country hospitalization. All but one hospital implemented transmission-based precautions for cases; 70% (76/109) continued precautions indefinitely. Overall, 94% (99/105; excluding hospitals with exclusively private rooms) and 55% (60/109) of hospitals screened roommates and wardmates, respectively. Frequency and timing of screening and policies regarding precautions for exposed patients varied. All hospitals used axilla and groin swabs, at minimum, for screening. Most (81%, 26/32) laboratories identified all clinically significant Candida isolates to species level, increasing from 48% to 85% (P < 0.001) in the 27 laboratories completing both 2018 and 2024 surveys. Twenty-four laboratories (75%) had standard operating procedures for processing screening specimens; 96% (23/24) used direct plating onto chromogenic agar. CONCLUSIONS: Despite progress in C. auris preparedness, areas for improvement remain. Variability in practice may be related to evidence gaps and resource constraints.