Ms Ema Manoilova1
1Western Health, Australia
Biography:
Ema Manoilova is a Senior Infection Control Consultant at Western Health with 18+ years of nursing experience. A credentialed gold-standard hand hygiene auditor, nurse immuniser, and HIV/BBV counsellor, she specialises in outbreak management, surveillance, and healthcare education. Currently pursuing a Master of Public Health.
Abstract:
Introduction
Candida auris has emerged as a priority antimicrobial-resistant pathogen since its identification in 2009, designated by the World Health Organization as a critical threat. Its environmental persistence, misidentification by conventional laboratory platforms, resistance to antifungal medications, and propensity for interfacility transmission present challenges for infection prevention. Clinical cases in the United States rose from 766 in 2020 to 6,304 in 2024, yet heterogeneity persists in screening protocols, diagnostic approaches, and outbreak response. This review examined how standardised screening in hospitalised patients influences identification and prevention of C. auris transmission.
Methods
A systematic search of CINAHL, PubMed, Scopus, and Web of Science returned 2,443 articles. Following PRISMA-guided screening, eight primary studies were retained. Included studies encompassed retrospective cohorts, cross-sectional surveillance evaluations, multi-facility outbreak investigations, and prospective colonisation monitoring across the United States, United Kingdom, Netherlands, India, and China. Thematic analysis was employed given methodological heterogeneity precluding meta-analysis.
Results
Three themes emerged: screening strategies and risk stratification, colonisation persistence and diagnostic challenges, and coordinated healthcare system responses. Colonisation prevalence varied markedly (0% to 17.6%), with patients from nursing home facilities and those with invasive devices representing highest-risk populations. Polymerase chain reaction detection demonstrated superior sensitivity over culture methods, suggesting surveillance data substantially underestimate prevalence. Multi-facility outbreaks revealed the operational costs of reactive rather than proactive detection.
Conclusion
Evidence supports risk-stratified screening, molecular diagnostic investment, and coordinated interfacility communication. Effective prevention requires workforce development, equitable resource distribution, and recognition of social determinants shaping transmission risk, alongside honest engagement with remaining evidence gaps.