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Candidozyma auris in the United States: Insights from the National Association of Long-Term Hospitals (NALTH) Network

Published online by Cambridge University Press:  23 June 2026

Kim Tran
Affiliation:
Rush University Medical Center
Mckenzi King
Affiliation:
Rush University Medical Center
Nidhi Undevia
Affiliation:
RML Specialty Hospital
Lahari Thotapalli
Affiliation:
Rush University Medical Center
Lisa Duffner
Affiliation:
RML Specialty Hospital
Alison Peterson
Affiliation:
RML Specialty Hospital
Rachel Medernach
Affiliation:
Rush University Medical Center
Mary Carl Froilan
Affiliation:
Rush University Medical Center
Aleksandra Kozicka
Affiliation:
Rush University Medical Center
Mary Hayden
Affiliation:
Rush University Medical Center
Sarah Sansom
Affiliation:
Rush University

Abstract

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Background: We queried long term acute care hospitals (LTACHs) within the NALTH network regarding facility characteristics, C. auris prevention practices, and perceived barriers to C. auris prevention. Methods: Participating facilities completed a REDCap survey of multiple choice, free response, and ranked choice questions. Quantitative and descriptive analyses were performed for completed surveys. Perceived barriers and important tools for C. auris prevention were assessed with ranked choice questions and analyzed by non-weighted counts. Results: Among 33 responses from 56 eligible LTACHs (Figure 1, Table 1), 23 (70%) had ever identified at least one case of C. auris infection or colonization. Eighteen of 33 (54%) reported identifying cases of C. auris within the past 3 months (Figure 2) and 9 of 33 (27%) had experienced suspected within-facility transmission. All facilities employed multimodal approaches for C. auris infection prevention (Table 2). More than half of LTACHs reported routine C. auris screening programs (21, 64%), including in response to a known C. auris case (n=15) and/or screening for asymptomatic colonization at the time of LTACH admission (n=12). The most frequently reported barriers to effective C. auris infection prevention included lack of communication between healthcare facilities at the time of patient transfer (n=16), lack of training and education for frontline staff (n=15), and lack of compliance with personal protective equipment (n=12). The most impactful methods anticipated to support future C. auris prevention included improved communication between facilities at the time of patient transfer (n=15), standardized protocols for C. auris decolonization (n=15), and standardized protocols for C. auris screening and isolation (n=14). Conclusion: Most participating LTACHs within the NALTH network reported firsthand experience with C. auris. Universally, responding facilities employed multimodal evidence-based infection prevention and control methods targeted against C. auris. Future research should focus on improving inter-facility communication of C. auris colonization or infection status, development of novel decolonization strategies, and standardization of surveillance practices.

A table showing characteristics of participating long-term acute care hospitals.

A table listing targeted prevention practices for suspected or confirmed cases of Candida auris and the percentage of facilities implementing each practice.

Map of the United States showing the geographic distribution of long-term acute care hospital participants by region.

A bar graph showing the number of Candidozyma auris cases identified in the past 3 months at participating long-term acute care hospitals.

Information

Type
Long Term Care
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America