The Society for Healthcare Epidemiology of America (SHEA) has released a new consensus statement with pediatric-specific recommendations for infection prevention and control of Candida auris, a multidrug-resistant fungal pathogen. The guidelines, published in the journal Antimicrobial Stewardship & Healthcare Epidemiology, focus on detecting and managing this emerging threat in children’s healthcare settings. According to the report, Candida auris poses unique challenges in pediatric populations due to differences in colonization patterns and limited pediatric data.

Below are the key takeaways from the new SHEA recommendations:

  • SHEA issued the first pediatric-specific guidelines for Candida auris, emphasizing early detection and strict contact precautions.
  • Children may carry the fungus without symptoms, making screening in high-risk units essential.
  • Recommendations stress the need for dedicated equipment and environmental cleaning in pediatric wards.
  • The guidelines call for improved antifungal stewardship to limit resistance in young patients.

Why Pediatric-Specific Guidelines Are Needed

Candida auris has caused outbreaks in healthcare facilities worldwide, but most infection control guidance has been based on adult data. The SHEA report notes that pediatric patients differ in their risk factors, including higher rates of colonization in neonatal intensive care units and unique challenges in cleaning medical devices used for children. The new consensus statement aims to close this gap by providing evidence-based recommendations tailored to infants, children, and adolescents.

Key Recommendations for Prevention

The SHEA guidelines recommend that healthcare facilities implement active surveillance for Candida auris in pediatric intensive care units and neonatal units, especially when there is a known outbreak or high community prevalence. Screening should include swabs from skin and stool, and positive cases should be placed under contact precautions in single rooms whenever possible. Staff should use dedicated equipment and ensure thorough environmental cleaning with disinfectants effective against the fungus.

Detection and Screening Strategies

According to the original report, early identification is critical because Candida auris can spread rapidly among vulnerable children. The guidelines suggest routine screening upon admission for high-risk patients, such as those with prolonged hospital stays, central lines, or recent exposure to affected facilities. Laboratories should be able to distinguish C. auris from other Candida species using specialized methods like MALDI-TOF mass spectrometry.

Infection Control Measures

The recommendations emphasize cohorting of colonized or infected pediatric patients and assigning dedicated nursing staff when possible. Environmental cleaning should use EPA-registered disinfectants with documented activity against C. auris. The guidelines also address the importance of hand hygiene, gowns, and gloves for all healthcare workers entering the patient’s room. For neonatal units, special attention is needed for equipment such as incubators and feeding tubes.

Antifungal Stewardship and Treatment Considerations

Because Candida auris is often resistant to multiple antifungal drugs, the SHEA statement calls for careful use of antifungals in pediatric settings to slow further resistance. Treatment decisions should be guided by susceptibility testing, and healthcare providers should consider consulting infectious disease specialists. The guidelines also outline when to consider decolonization strategies, though they caution that evidence in children is limited.

Frequently Asked Questions

What makes Candida auris dangerous in children?

Candida auris can cause severe bloodstream infections and spreads easily in healthcare settings. In children, especially premature infants and those with weakened immune systems, the fungus can lead to prolonged hospital stays and high mortality. Its multidrug resistance makes treatment difficult, and infected children may require prolonged isolation.

How do the new pediatric guidelines differ from adult recommendations?

The pediatric guidelines address unique factors such as differences in skin colonization sites, the use of feeding tubes and incubators, and the need for age-appropriate disinfectants. Adult recommendations often focus on long-term care facilities, while pediatric guidance emphasizes neonatal and pediatric ICUs. Screening protocols and isolation strategies are adapted for children, including considerations for family visits and developmental needs.

What should parents know about Candida auris?

Parents should understand that Candida auris spreads through contact with contaminated surfaces or equipment. Hospitals should inform families if their child is colonized or infected. Strict hand hygiene and limiting unnecessary visitors are important. The fungal infection is rarely a concern for healthy children outside healthcare settings, but families should follow all recommended infection control measures during a hospital stay.

This is an original report by Vital Signs Today, informed by reporting from Medical Xpress. Read the original source.

This article is for information only and is not medical advice. See our Medical Disclaimer.