{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:47:17Z","timestamp":1792057637936,"version":"4.4.0"},"reference-count":15,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"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":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X25103267_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      Describe the first healthcare-associated outbreak of\n                      <jats:italic>Candida auris<\/jats:italic>\n                      in Maricopa County, Arizona. Also, outline the Maricopa County Department of Public Health (MCDPH) response activities to halt transmission and identify affected healthcare facilities (HCFs) and contacts colonized with\n                      <jats:italic>C. auris<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103267_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      At HCFs with confirmed\n                      <jats:italic>C. auris<\/jats:italic>\n                      cases (i.e., exposed HCFs), MCDPH provided virtual infection control assessment and response activities, including contact investigations among hospitalized patients and point prevalence surveys (PPSs) to identify ongoing transmission. Confirmed\n                      <jats:italic>C. auris<\/jats:italic>\n                      cases included\n                      <jats:italic>C. auris<\/jats:italic>\n                      detected by cultures or polymerase chain reaction (PCR) in a hospitalized patient. Clinical cases had\n                      <jats:italic>C. auris<\/jats:italic>\n                      from cultures obtained during routine care in a hospitalized patient. Colonized cases included C.\n                      <jats:italic>auris<\/jats:italic>\n                      detected by PCR obtained from hospitalized patients for screening purposes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103267_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      On April 21, 2022, the first clinical case was identified, resulting in an outbreak with\n                      <jats:italic>C. auris<\/jats:italic>\n                      screening at 28 exposed HCFs. In total, 39 clinical\n                      <jats:italic>C. auris<\/jats:italic>\n                      cases were reported. Among 1,994 contacts identified, 899 (45.0%) were screened, 8 (0.4%) declined screening, and 1,087 (54.5%) were ineligible for screening (i.e., no longer hospitalized in Maricopa County). Among screened patients, 158 (17.6%) were colonized with\n                      <jats:italic>C. auris<\/jats:italic>\n                      ; 15 (9.5%) colonized contacts later acquired clinical infections. This outbreak concluded on February 23, 2023, after 2 consecutive PPSs yielded no\n                      <jats:italic>C. auris<\/jats:italic>\n                      detection at exposed HCFs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103267_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      The first\n                      <jats:italic>C. auris<\/jats:italic>\n                      outbreak in Maricopa County highlights the coordinated efforts between HCFs, laboratories, and public health to identify exposed HCFs, screen contacts, and halt\n                      <jats:italic>C. auris<\/jats:italic>\n                      transmission.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2025.10326","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T11:46:50Z","timestamp":1770724010000},"page":"483-487","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Local public health response to first\n                    <i>Candida auris<\/i>\n                    outbreak spanning\u00a028 healthcare facilities\u2014Maricopa County, Arizona, April\u00a02022\u2013February 2023"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9902-9742","authenticated-orcid":false,"given":"Heather L.","family":"Leahy","sequence":"first","affiliation":[{"name":"Maricopa County Department of Public Health"},{"name":"Arizona Department of Health Services"},{"name":"Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Bailey","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JulieAnna","family":"Rivas","sequence":"additional","affiliation":[{"name":"Arizona Department of Health Services"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Hernandez-Cubias","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8019-4863","authenticated-orcid":false,"given":"Kaitlyn","family":"Chorbi","sequence":"additional","affiliation":[{"name":"Arizona Department of Health Services"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Munoz","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3100-2271","authenticated-orcid":false,"given":"Rachana","family":"Bhattarai","sequence":"additional","affiliation":[{"name":"Arizona Department of Health Services"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3601-6976","authenticated-orcid":false,"given":"Zoha","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1891-919X","authenticated-orcid":false,"given":"Ariella P.","family":"Dale","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3978-614X","authenticated-orcid":false,"given":"Karen","family":"Zabel","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Nicholas","family":"Staab","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Sunenshine","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siru","family":"Prasai","sequence":"additional","affiliation":[{"name":"Maricopa County Department of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"S0899823X25103267_ref12","unstructured":"12. Infection Control Assessment and Response (ICAR) Tool for General Infection Prevention and Control (IPC) Across Settings. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/healthcare-associated-infections\/php\/toolkit\/icar.html. Published 2024. Accessed February 28, 2025."},{"key":"S0899823X25103267_ref1","unstructured":"1. Antibiotic Resistance Coordination and Strategy Unit. Antibiotic resistance threats in the United States, Antibiotic resistance threats in the United States. 2019. https:\/\/stacks.cdc.gov\/view\/cdc\/82532. Published 2019. Accessed July 9, 2024."},{"key":"S0899823X25103267_ref9","unstructured":"9. Arizona Administrative Code Title 9. Health Services. Arizona Department of Health Services website. https:\/\/apps.azsos.gov\/public_services\/Title_09\/9-06.pdf. Published 2023. Accessed July 10, 2024."},{"key":"S0899823X25103267_ref3","unstructured":"3. Tracking C. auris . Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/candida-auris\/tracking-c-auris\/index.html. Published May 2014. Accessed July 10, 2024."},{"key":"S0899823X25103267_ref8","doi-asserted-by":"crossref","first-page":"658329","DOI":"10.3389\/fmicb.2021.658329","article-title":"Retrospective analysis of the clinical characteristics of Candida auris infection worldwide from 2009 to 2020","volume":"12","author":"Hu","year":"2021","journal-title":"Front Microbiol"},{"key":"S0899823X25103267_ref15","unstructured":"15. MDRO Prevention Strategies. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/healthcare-associated-infections\/php\/preventing-mdros\/mdro-prevention-strategies.html. Published 2024. Accessed January 7, 2025."},{"key":"S0899823X25103267_ref13","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.ajic.2024.05.010","article-title":"Candida auris inpatient screening in collaboration with the public health department","volume":"52","author":"Greco","year":"2024","journal-title":"Am J Infect Control"},{"key":"S0899823X25103267_ref7","doi-asserted-by":"crossref","first-page":"e753","DOI":"10.1093\/cid\/ciaa1462","article-title":"Factors associated with Candida auris colonization and transmission in skilled nursing facilities with ventilator units, New York, 2016\u20132018","volume":"72","author":"Rossow","year":"2021","journal-title":"Clin Infect Dis"},{"key":"S0899823X25103267_ref4","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.3201\/eid2410.180649","article-title":"Candida auris in healthcare facilities, New York, USA, 2013\u20132017","volume":"24","author":"Adams","year":"2018","journal-title":"Emerg Infect Dis"},{"key":"S0899823X25103267_ref5","doi-asserted-by":"crossref","first-page":"e718","DOI":"10.1093\/cid\/ciaa435","article-title":"Regional emergence of Candida auris in Chicago and lessons learned from intensive follow-up at 1 ventilator-capable skilled nursing facility","volume":"71","author":"Pacilli","year":"2020","journal-title":"Clin Infect Dis"},{"key":"S0899823X25103267_ref6","doi-asserted-by":"crossref","first-page":"514","DOI":"10.15585\/mmwr.mm6619a7","article-title":"Notes from the field: ongoing transmission of Candida auris in Health Care Facilities \u2014 United States, June 2016\u2013May 2017","volume":"66","author":"Tsay","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0899823X25103267_ref14","unstructured":"14. MDRO Containment Strategy. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/healthcare-associated-infections\/php\/preventing-mdros\/mdro-containment-strategy.html. Published 2024. Accessed January 7, 2025."},{"key":"S0899823X25103267_ref10","unstructured":"10. U.S. Census Bureau QuickFacts: Maricopa County, Arizona. United States\u00a0Census Bureau website. https:\/\/www.census.gov\/quickfacts\/maricopacountyarizona. Published 2023. Accessed July 10, 2024."},{"key":"S0899823X25103267_ref2","unstructured":"2. Increasing Threat of Spread of Antimicrobial-resistant Fungus in Healthcare Facilities. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/media\/releases\/2023\/p0320-cauris.html. Published 2023. Accessed July 9, 2024."},{"key":"S0899823X25103267_ref11","unstructured":"11. Interim Guidance for a Public Health Response to Contain Novel or Targeted Multidrug-resistant Organisms (MDROs). Centers for Disease Control and Prevention website. https:\/\/stacks.cdc.gov\/view\/cdc\/79094 Published 2019. Accessed July 10, 2024."}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X25103267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:11:47Z","timestamp":1792055507000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X25103267\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["S0899823X25103267"],"URL":"https:\/\/doi.org\/10.1017\/ice.2025.10326","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]},"assertion":[{"value":"\u00a9 Centers for Disease Control and Prevention, 2026","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}