What You Need To Know
Date: September 23, 2024
Key Points:
- Candida auris (C. auris) and carbapenemase-producing organisms (CPOs) are nationally notifiable healthcare-associated pathogens classified as urgent threats to public health by the Centers for Disease Control and Prevention (CDC). The New Jersey Department of Health (NJDOH) requests your help in promptly identifying these pathogens so that they can be contained and transmission prevented.
- Both the testing laboratory and the sending facility should report any specimens that test positive for C. auris or a carbapenemase gene within 24 hours to the NJDOH and the local health department (see “Contact Information”).
- NJDOH’s Communicable Disease Reporting and Surveillance System (CDRSS) is currently not able to receive C. auris or CPO case reports and/or electronic laboratory results (ELR). Direct reporting of positives via secure or encrypted email to NJDOH is required.
- Laboratory Lookback: Laboratories conducting “in-house” testing, that have not previously reported positives to NJDOH, should conduct a laboratory lookback to identify and retrospectively report all positive C. auris and CPO specimens identified since their start of “in-house” testing.
Specifics:
Retrospective Laboratory Surveillance and Case Reporting
- All laboratories conducting C. auris and/or CPO testing that have not been directly reporting positive results to NJDOH should conduct a laboratory lookback to identify all positive specimens identified since “in-house” testing started in their facility and report to NJDOH.
- Laboratories should provide the following information (at minimum) for every positive specimen identified during the laboratory lookback:
- Patient full name, patient date of birth, patient sex, facility of specimen collection, specimen collection date, specimen collection source, specimen results
- Laboratories that do not conduct routine CPO testing can submit carbapenem-resistant organism isolates that meet current submission criteria to NJDOH for further testing.
Positive Result Reporting and Communication Expectations
- Laboratories that detect C. auris and/or CPO(s) from any specimen source should immediately (i.e., within 24 hours of identification) report the positive result to NJDOH.
- Healthcare facilities where a C. auris and/or CPO positive specimen is collected should immediately (i.e., within 24 hours of identification) report the positive result to NJDOH.
- Laboratories that detect C. auris and/or CPO(s) from any specimen source should immediately (i.e., within 24 hours of identification) report the positive result to the collecting facility.
- Healthcare facilities where a C. auris and/or CPO positive specimen is collected should immediately (i.e., within 24 hours of identification) report the positive result to the healthcare facilities where a positive patient was admitted from and subsequently discharged to.
- Clinical cases and screening cases of C. auris and CPO(s) are counted distinctly, which requires additional reporting of positive clinical specimens collected from patients previously identified to be colonized.
Candida auris: Confirmatory Laboratory Criteria
- The following are each considered confirmatory laboratory evidence for C. auris:
- Detection of C. auris in a specimen from a swab obtained for the purpose of colonization screening using either culture or validated culture-independent test (e.g., nucleic acid amplification test [NAAT]), OR
- Detection of C. auris in a clinical specimen obtained during the normal course of care for diagnostic or treatment purposes using either culture or a validated culture-independent test (e.g., NAAT)
Carbapenemase-Producing Organisms: Confirmatory Laboratory Criteria
- The following are each considered confirmatory laboratory evidence for CPOs:
- Positive phenotypic test result for carbapenemase production in a specimen, OR
- Positive molecular test result detecting a carbapenemase gene (with or without organism identification), OR
- Detection of carbapenemase gene by next generation sequencing (NGS)