Candida auris: What literature exists to inform control of outbreaks in healthcare settings?
Bibliographic record
Abstract
Background: Candida auris (C. auris) has been identified as an emerging pathogen of interest in healthcare settings. Its resistance to antimicrobials, high mortality rates, ability to persist in the environment and increasing instances of outbreaks in healthcare settings constitute major concerns among healthcare practitioners across the globe. To address concerns regarding preventing transmission of C. auris, the Public Health Agency of Canada (PHAC) conducted a literature review to inform guidance for the infection prevention and control of C. auris in hospitals and long-term care facilities (LTC). Methods: Electronic databases were searched to identify peer-reviewed evidence published between database inception until September 7, 2023. Peer-reviewed primary evidence and literature reviews, in English or French, reporting on infection prevention and control (IPC) practices put into place to prevent transmission of C. auris in healthcare settings were eligible for inclusion. Title and abstract screening, full-text review, critical appraisal, and data extraction processes were performed by two reviewers using DistillerSR systematic review software and the PHAC Infection Prevention and Control Critical Appraisal Toolkit. A scan of grey literature was also conducted to inform the review. Results: Thirty-two articles of medium- to high-quality detailing C. auris IPC were included in the review. Settings reporting no transmission beyond the index case were more likely to report the use of risk-factor-based screening, private accommodation with dedicated toileting facilities, the use of personal protective equipment (PPE) consisting of gown and gloves at all times and the application of no-touch cleaners and disinfectants. Conclusion: Multiple IPC interventions appear to be effective at minimizing transmission. However, determining effectiveness is challenging due to variability in intervention reporting and due to the lack of understanding of C. auris burdens before and after their implementation. Increased vigilance with screening and reporting would be advisable, and future work would benefit from multi-centre comparison of interventions using prevalence data.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.042 | 0.238 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.009 | 0.006 |
| Bibliometrics | 0.030 | 0.019 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.012 | 0.012 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.007 | 0.004 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".