Assessment of Environmental and Occupational Exposure while Working with Candida auris a Multidrug Resistant (MDR) Fungus in the Animal Facility.

In less than a decade since its identification in 2009, the emerging fungal pathogen Candida auris has become a major public health threat due to its multidrug resistant (MDR) phenotype, high transmissibility, and high mortality. Unlike any other Candida species, C. auris has acquired high levels of resistance to an already limited arsenal of antifungals. As an emerging pathogen, there are currently a limited number of documented murine models of C. auris infection. These animal models use inoculums as high as 10 7 -10 8 cells per mouse, and the environmental and occupational exposure of working with these models has not been clearly defined. Using an intravenous model of C. auris infection, this study determined that shedding of the organism is dose-dependent. C. auris was detected in the cage bedding when mice were infected with 10 7 and 10 8 cells, but not with doses of 10 5 and 10 6 cells. Potential for exposure to C. auris during necropsies and when working with infected tissues was also demonstrated. To mitigate these potential exposures, a rigorous buddy system workflow, biomonitoring and disinfection procedures were developed that can be used to prevent accidental exposures when using small animal models of C. auris infection.