P-340. Evaluating the Efficacy of Nasal Iodophor Antisepsis in Reducing Candida auris Nasal Carriage in Nursing Home Residents

Background

Candida auris is an emerging drug-resistant yeast that is spreading rapidly in U.S. healthcare facilities, particularly in nursing homes. Like MRSA, C. auris is commonly found in the nose, raising questions about whether nasal iodophor application can reduce carriage.

Methods

We evaluated the impact of iodophor on C. auris nasal carriage at two nursing homes. Nasal carriers were identified from point prevalence sampling of bilateral nares of residents for both C. auris and MRSA conducted at each nursing home.

Nasal iodophor was given to carriers according to a 5-day twice-daily decolonization protocol. Nasal swabs for C. auris and MRSA culture were collected on Day 1 (pre-iodophor), Day 5 (last day of iodophor administration), and Day 9 (4 days after iodophor cessation). Bioburden was assessed on an ordinal scale (none = 0, few =1, 1+ = 2, 2+ = 3, 3+ = 4, and 4+ = 5). Paired t-tests compared C. auris and MRSA bioburden between timepoints.

Results

Twenty-two residents with C. auris nares carriage completed the evaluation. Seven (32%) also harbored MRSA. Between Days 1 and 5, mean nares bioburden decreased from 3.6 to 2.8 for C. auris (P=0.03) and from 4.3 to 2.3 for MRSA (P=0.02) (Figure). Comparing Day 9 to Day 1, mean C. auris bioburden at Day 9 was 2.8 (P=0.01) and mean MRSA bioburden at Day 9 was 3.1 (P=0.14).

Conclusion

Five days of nasal iodophor antisepsis appeared to suppress both C. auris and MRSA carriage. Rebound growth four days after iodophor discontinuation was seen for MRSA but not C. auris, although numbers were small. Nasal iodophor may be an effective strategy for reducing nasal carriage in high-risk settings. The value of repeated antisepsis for sustained bioburden reduction was not evaluated in this study.

Disclosures

Raveena D. Singh, MA, Xttrium Laboratories: Conducting studies in which participating hospital patients received contributed antiseptic products outside the submitted work Raheeb Saavedra, AS, Xttrium Laboratories: Conducting studies in which participating hospital patients received contributed antiseptic products outside the submitted work Susan Huang, MD, MPH, Xttrium Laboratories: Conducting studies in which participating hospital patients received contributed antiseptic products outside the submitted work