{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T02:08:37Z","timestamp":1774490917285,"version":"3.50.1"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24000989_as1\"><jats:title>Background:<\/jats:title><jats:p><jats:italic>Candida auris<\/jats:italic> is an emerging fungal pathogen increasingly recognized as a cause of healthcare-associated infections including outbreaks.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000989_as2\"><jats:title>Methods:<\/jats:title><jats:p>We performed a mixed-methods study to characterize the emergence of <jats:italic>C. auris<\/jats:italic> 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 <jats:italic>C. auris<\/jats:italic> 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 <jats:italic>C. auris<\/jats:italic> 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 \u2265 75th percentile or an ADI \u2265 80th percentile considered severely disadvantaged. We summarized infection control assessments at SNFs with outbreaks using a qualitative analysis.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000989_as3\"><jats:title>Results:<\/jats:title><jats:p>A total of 140 individuals tested positive for <jats:italic>C. auris<\/jats:italic> 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 <jats:italic>C. auris<\/jats:italic> 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.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000989_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>Neighborhood socioeconomic vulnerability may contribute to the emergence and transmission of <jats:italic>C. auris<\/jats:italic> in a community.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.98","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T02:02:10Z","timestamp":1722304930000},"page":"1183-1189","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["<i>C. auris<\/i> and neighborhood socioeconomic vulnerability in the state of Maryland from 2019 to 2022"],"prefix":"10.1017","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6160-0606","authenticated-orcid":false,"given":"L. 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