Hospital C. Auris Infection Outbreak Linked to Reusable Armpit Thermometers: Report

A large scale outbreak of C. auris infections was linked to armpit thermometers used at a hospital in the U.K., according to the findings of a new study. 

Researchers detected an outbreak of candida auris, a drug-resistant fungal pathogen, in the intensive care unit (ICU) of the Oxford University Hospital in the United Kingdom. Researchers from the hospital and U.K. health regulators indicated cleaning failed to prevent the spread of infections, and new cases only stopped being reported after the thermometers were removed from patient rooms, according to findings published last week in the New England Journal of Medicine.

A total of 70 patients were diagnosed with the C. auris infection at the hospital between February 2, 2015, and August 31, 2017. Invasive infections developed in seven patients. More than 94% of the patients were admitted to the ICU before being diagnosed, indicating the source of the infection was primarily at the hospital.

Researchers instituted an intensive patient and environmental screening program and interventions. They took samples from patients and items in the hospital environment, and determined that exposure to skin-surface axillary temperature probes was the source of the outbreak. These devices are reusable thermometers placed under the patient’s armpit to take the temperature reading.

Exposure to the thermometers increased a person’s risk of getting the C. auris infection sevenfold.

“The transmission of C. auris in this hospital outbreak was found to be linked to reusable axillary temperature probes, indicating that this emerging pathogen can persist in the environment and be transmitted in health care settings,” the study authors wrote.

The fungal strain was detected on the reusable equipment even after cleaning interventions were introduced. New cases of infection were reduced only after the thermometers were removed from patient rooms.

The hospital practiced continuous temperature monitoring with the skin-surface thermometers as part of routine care for many patients in the ICU. The probes were cleaned between uses, but the pathogen was able to survive and infect patients.

C. auris is a fungus that is resistant to many antibiotics. At times, it can be fatal. It was recently linked to outbreaks around the world and is known to survive on hospital surfaces for long periods of time. The U.S. Centers for Disease Control and Prevention (CDC) issued an advisory in 2016, after the pathogen was detected for the first time in the U.S.

In 2017, C. auris was responsible for another hospital-linked outbreak which eventually sickened 122 people across seven states. Most cases detected in the U.S. have been detected in New York City, New Jersey and Chicago.