1268. Transmissibility of Candida auris by Type of Inpatient Healthcare Facility

Abstract

Poster Abstracts • OFID 2018:5 (Suppl 1) • S387 and April 2018. We estimated facility transmissibility and facility reproduction number (number infected by one index colonized patient per day, and per stay, respectively, at the facility) of C. auris based on estimated colonization pressure, a count of newly colonized patients between successive surveys at the same facility, and mean lengths of stay at facilities (estimated from CMS administrative data). The results were summarized by facility type: acute care hospital (ACH), long-term acute care hospital (LTACH) or ventilator unit at skilled nursing facility (VSNF), and were compared with previous estimates for transmissibility of carbapenem-resistant Enterobacteriaceae (CRE). Results. Swabs were collected from 13 ACHs, 12 LTACHs, and 11 VSNFs. The C. auris facility reproduction number may exceed the critical value of 1 in both ACHs and VSNFs, and may exceed that for CRE in ACHs (table). Conclusion. Transmissibility of C. auris is comparable to that of CRE. The trans-missibility within VSNFs emphasizes their potential role as amplifiers in the outbreak. Understanding transmissibility by facility type helps evaluate the potential impact of interventions in various settings. Table: Transmissibility of C. auris by Facility Type Facility Type C. auris Transmissibility (per Day) (Median, IQR) C. auris reproduction number (per Stay) (Median, IQR) CRE Transmissibility a (per Day) (Mean, 95% CI) CRE Reproduction Number a ACH 0.218 (0.215-0.221) 1.05 (1.04-1.07) 0.104 (0.079-0.138) 0.50 LTACH 0.035 (0.019-0.045) 0.73 (0.40-0.97) 0.042 (0.036-0.049) 1.61 VSNF 0.019 (0.014-0.023) 1.05 (0.70-1.27)-a Previous estimates (Poster 429, SHEA 2018), for comparison.