The Virginia Department of Health (VDH) has asked VHCA-VCAL to share information with members on containing multi-drug resistant organisms (MRDOs). The information from VDH includes recommendations for personal protective equipment in nursing homes, a clinician letter on c. auris, and updates to the Carbapenem-Resistant Organisms 

Recommendations for Personal Protective Equipment (PPE) in Nursing Homes

The CDC has updated their guidance for PPE in nursing homes to prevent Novel or Targeted MDROs. Guidance now includes a new measure called enhanced barrier precautions that is to be used in low-risk patients during high-contact activities. This allows nursing homes to relax previous recommendations for transmission-based precautions in select patient populations. 

Candida auris (C. auris)

A clinician letter was recently sent out informing healthcare providers about a current investigation and available resources.

1. auris can cause invasive, life threatening infections and is an urgent public health concern due to its tendency to rapidly and easily spread in healthcare settings, its frequent resistance to antifungal agents, and because it can be difficult to identify using commonly available laboratory techniques. A colonized case patient was recently identified in Virginia after receiving healthcare in Maryland. The Virginia Department of Health (VDH) has been working to identify all healthcare contacts of that case to ensure appropriate actions are taken, including lab testing of high-risk contacts to rule out C. auris colonization. It is possible that additional
   cases will be identified.

The letter encourages providers to be aware of risk factors for C. auris (e.g., international healthcare exposure, indwelling catheters, tracheostomies, multiple underlying medical conditions, immunocompromising conditions, and receipt of broad-spectrum antibiotics).

Please visit the newly created VDH C. auris webpage for the most up-to-date information. The webpage includes infection prevention recommendations, disease reporting requirements, and the public health response for a single case. 

Carbapenem-Resistant Organisms (CROs)

Updates have been made to the VDH CRO webpage. Infection prevention resources for nursing homes have been updated to include the most recent guidance from CDC. 2018 Virginia testing data have been added to the website. Check back in the near future for quarterly reports on carbapenemase-producing organism case counts.

In addition, a session at the 2019 Annual Convention, Multi-Faceted Strategies to Reduce Infections Caused by Public Enemy #1, will offer advice and information on multi-drug resistant organisms like C. auris.