C. auris and neighborhood socioeconomic vulnerability in the state of Maryland from 2019 to 2022

• Published in: Infection control and hospital epidemiology 2024-07, Vol.45 (10), p.1183-1189
• Main Authors: Smith, L. Leigh, Falvey, Jason, Grace, Brittany, Vaeth, Elisabeth, Rubin, Jamie, Perlmutter, Rebecca, Blythe, David, Hawkins, Daryl, Mbuthia, Martha, Roghmann, Mary-Claire, Rock, Clare, Leekha, Surbhi
• Format: Article
• Language: English
• Subjects: Censuses; Content analysis; Disease control; Disease transmission; Epidemiology; Health care access; Health facilities; Infectious diseases; Laboratories; Neighborhoods; Original Article; Outbreaks; Pathogens; Prevention; Public health; Qualitative analysis; Socioeconomic factors; Socioeconomic status; Socioeconomics; Workforce planning
• ISSN: 0899-823X; 1559-6834; 1559-6834
• DOI: 10.1017/ice.2024.98

is an emerging fungal pathogen increasingly recognized as a cause of healthcare-associated infections including outbreaks. We performed a mixed-methods study to characterize the emergence of in the state of Maryland from 2019 to 2022, with a focus on socioeconomic vulnerability and infection prevention opportunities. We describe all case-patients of among Maryland residents from June 2019 to December 2021 detected by Maryland Department of Health. We compared neighborhood socioeconomic characteristics of skilled nursing facilities (SNFs) with and without transmission outbreaks using both the social vulnerability index (SVI) and the area deprivation index (ADI). The SVI and the ADI were obtained at the state level, with an SVI ≥ 75th percentile or an ADI ≥ 80th percentile considered severely disadvantaged. We summarized infection control assessments at SNFs with outbreaks using a qualitative analysis. A total of 140 individuals tested positive for in the study period in Maryland; 46 (33%) had a positive clinical culture. Sixty (43%) were associated with a SNF, 37 (26%) were ventilated, and 87 (62%) had a documented wound. Separate facility-level neighborhood analysis showed SNFs with likely transmission were disproportionately located in neighborhoods in the top quartile of deprivation by the SVI, characterized by low socioeconomic status and high proportion of racial/ethnic minorities. Multiple infection control deficiencies were noted at these SNFs. Neighborhood socioeconomic vulnerability may contribute to the emergence and transmission of in a community.