Becker's Clinical Quality & Infection Control

8 INFECTION CONTROL How Scripps, UCLA Health nipped spread of deadly fungus at start of pandemic By Mackenzie Bean T wo healthcare organizations in Southern California imple- mented comprehensive efforts to prevent the spread of a deadly fungus amid the early days of the pandemic, according to two case studies presented June 29 at the Association for Professionals in Infection Control and Epidemiology's virtual annual conference. La Jolla, Calif.-based Scripps Memorial Hospital received San Diego County's first known Candida auris case during the pandemic's first surge in March 2020. e patient was hospitalized and in isolation for 47 days. During this time, the hospital implemented aggressive cleaning measures in all patient rooms and conducted routine sur- veillance testing to ensure the fungal infection did not spread. After C. auris cases started to surge in Southern California in summer 2020, Los Angeles-based UCLA Health created a mul- tilevel notification system to identify potential cases early and prevent transmission. Infection preventionists and the system's health IT team set up its EMR system to screen every new pa- tient for COVID-19 and C. auris. The system flagged high-risk patients for testing at its in-house lab and triggered reminders about strict cleaning protocols for C. auris patients' rooms, among other capabilities. "The fact that these two teams recognized this threat and were able to mobilize so quickly and effectively while also on high alert for COVID is remarkable," Ann Marie Pettis, RN and presi- dent of the association said in a news release. "Their case studies demonstrate how important it is that hospitals, clinics and long- term care facilities have enough infection preventionists and resources to train staff and monitor safety protocols so they can prevent harm on multiple fronts." C. auris is an emerging fungus that causes severe or even fatal infections. It is difficult to detect with standard laboratory methods and resistant to most antifungal drugs, according to the CDC. The virus has infected nearly 1,800 people in 15 states and Washington, D.C., since it was first found in the U.S. in 2015. n 13 states skipped infection control surveys during pandemic, inspector general finds By Mackenzie Bean T hirteen states ignored CMS recommendations and did not perform targeted infection control surveys to prepare for COVID-19 patients last year, HHS' Office of Inspector General said in a June 28 report. Once COVID-19 emerged, CMS requested — but couldn't require — hospitals to perform special infection control surveys. As of Aug. 17, 2020, state survey agencies had only performed these surveys at about 13 percent of hospitals due to CMS' limited authority over accredited hospitals, according to the report. No infection control surveys were performed in Ala- bama, Alaska, Delaware, Georgia, Massachusetts, Mon- tana, New Hampshire, New Mexico, Oregon, Pennsylva- nia, South Dakota, Vermont and Wyoming. As of March 2, seven of these states still hadn't performed a survey. In February 2019, CMS also urged all accredited hospi- tals to plan for emerging infectious diseases but cannot determine whether facilities updated their emergency preparedness plans until next year because of its quality and safety inspection cycles. CMS hospital preparedness measures for an emerging infectious disease were well-designed and implement- ed, but the agency lacks the oversight authority to en- sure adherence to these measures, the inspector gen- eral concluded. "As a result of these limitations, CMS could not ensure that accredited hospitals would continue to provide quality care and operate safely during the COVID-19 emergency, and cannot ensure quality and safety at accredited hospi- tals when a future emerging infectious disease threatens the United States," the inspector general's report stated. The report recommends CMS make regulatory changes that permit the agency to require hospitals to perform special surveys after it issues new participation require- ments or guidelines during a public health emergency. n "The fact that these two teams recognized this threat and were able to mobilize so quickly and effectively while also on high alert for COVID is remarkable." - Ann Marie Pettis, RN, president of APIC

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