{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:45:51Z","timestamp":1787615151897,"version":"build-2736575974"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"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":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X25102171_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      To describe the mitigation strategies for a\n                      <jats:italic>Candida auris<\/jats:italic>\n                      outbreak in a cardiothoracic transplant intensive care unit (CTICU) and its implications for infection prevention practices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102171_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study from July 2023 to February 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102171_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>A large academic medical center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102171_as4\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multidisciplinary team convened to conduct the outbreak investigation and develop mitigation strategies in the CTICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102171_as5\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      From July 2023 to February 2024, 34 possible hospital-onset cases of\n                      <jats:italic>C. auris<\/jats:italic>\n                      were identified in our CTICU. Whole-genome sequencing and phylogenetic analysis based on pairwise single nucleotide polymorphism (WG-SNP) distance revealed two distinct outbreak clusters. Of the 34 patients, 11 (32.3%) were solid organ transplant recipients and 12 (35.3%) had a mechanical circulatory support device. Of the cohort, only 11\/34 (32.3%) had prior exposure to high-risk healthcare facilities within six months prior to admission, as follows: acute inpatient rehabilitation facilities (AIRs) (n = 5, 14.7%), skilled nursing facilities (SNFs) (n = 3, 8.8%), and long-term acute care hospitals (LTACHs) (n = 3, 8.8%). The cohort had a median of 22.0 antibiotic-days prior to their positive results. Five (14.7%) patients had\n                      <jats:italic>C. auris<\/jats:italic>\n                      candidemia, three of whom expired likely due to infection. Infection Prevention (IP) interventions addressed several modes of transmission, including healthcare personnel hands, shared patient equipment, and the environment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25102171_as6\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Our experience suggests that the epidemiology of\n                      <jats:italic>C. auris<\/jats:italic>\n                      may be changing, pointing towards a rising prevalence in acute care settings. IP interventions targeting hand hygiene behavior and promoting centralizing cleaning and disinfection of shared patient equipment may have contributed to outbreak resolution.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2025.10217","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T05:57:52Z","timestamp":1750658272000},"page":"789-796","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["<i>Candida auris<\/i>\n                    outbreak in a cardiothoracic transplant intensive care unit: implications for infection prevention practices and keeping pace with an evolving landscape"],"prefix":"10.1017","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9768-4095","authenticated-orcid":false,"given":"Shardul N.","family":"Rathod","sequence":"first","affiliation":[{"name":"Northwestern Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Barajas","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooks I.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"},{"name":"Northwestern Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Malczynski","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5385-354X","authenticated-orcid":false,"given":"W.Justin","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Weslander","sequence":"additional","affiliation":[{"name":"Department of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Bulger","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Stone","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Al-Qamari","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine and Northwestern Medicine"},{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie M.","family":"Bertram","sequence":"additional","affiliation":[{"name":"Department of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah H.","family":"Sutton","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital"},{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Stosor","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"},{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Qi","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"},{"name":"Northwestern Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa R.","family":"Zembower","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital"},{"name":"Northwestern University Feinberg School of Medicine"},{"name":"Northwestern Memorial Hospital"},{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen K.","family":"Bolon","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital"},{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"S0899823X25102171_ref16","unstructured":"16. Centers for Disease Control and Prevention. Multidrug-Resistant Organism & Clostridioides difficile Infection (MDRO\/CDI) Module. 2024. 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Centers for Disease Control and Prevention. About Candida auris (C. auris). 2023. Accessed May 12, 2024 from https:\/\/www.cdc.gov\/candida-auris\/about\/index.html."},{"key":"S0899823X25102171_ref29","unstructured":"29. World Health Organization. WHO research agenda for hand hygiene in health care 2023-2030: summary. 2023. Accessed August 11, 2024 from https:\/\/www.who.int\/publications\/i\/item\/9789240073715."},{"key":"S0899823X25102171_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa233"},{"key":"S0899823X25102171_ref15","unstructured":"15. Centers for Disease Control and Preventiona. Tracking Candida auris. 2024. 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