Tracing the Source: A Data-Driven Candida Auris Investigation Across Care Settings

Session Description: In mid-2024, our facility was notified by the health department that several recently discharged patients had tested positive for Candida auris (C. auris). Initial mapping of patient movements highlighted potential transmission points but lacked a clear source. We proposed three hypotheses: 1) intrafacility transmission via the environment or indirect contact, 2) unrecognized colonization at the time of admission, or 3) both. Each scenario implied accumulating bioburden in our environment, prompting the Infection Prevention (IP) team to develop a mitigation strategy.
A multidisciplinary group implemented horizontal controls: decluttering of nurses’ stations, cleaning product evaluations, and reinforced transmission-based precautions. A retrospective review of known cases revealed a common factor—admission from Long Term Acute Care Hospitals (LTACs). Six of eight patients had come from four different LTACs, leading to a 90-day trial to collect expanded data and assess correlations. Vertical strategies were introduced, including enhanced terminal cleaning, screening at first point of contact, and targeted surveillance testing. Dry hydrogen peroxide (DHP) technology was trialed as an additional environmental control.
Over 200 patient samples were evaluated, examining variables such as age, sex, multi-drug resistant organism (MDRO) history, medical device use, dialysis, wound type, and LTAC origin. Analysis identified one specific LTAC contributing a disproportionate number of positive cases. This insight allowed us to scale back some broader mitigation efforts while introducing focused protocols for patients from that facility.
Our presentation will walk attendees through the investigative process, the dual mitigation framework, and how data interpretation led to targeted, sustainable interventions. As we continue caring for medically complex patients, we share our lessons in balancing broad environmental controls with precise, data-driven infection prevention strategies to limit C. auris transmission.

Bonnie Berkley

Infection Preventionist, Northeast Methodist Hospital/ Methodist Healthcare System/ HCA

Bonnie Berkley, MPH, is an Infection Preventionist at an acute care facility in South Texas. With a background in public health research and program implementation, she brings a systems-thinking approach to every challenge. Prior to her current role, she worked in prostate cancer research and chronic disease prevention, focusing on sustainable program development and evaluation. Her passion lies in building infection prevention processes that are effective, scalable, and don’t rely on daily oversight from the IP team—ensuring long-term resilience within healthcare systems. She is particularly interested in applying data to guide targeted mitigation strategies and improve patient safety in high-risk environments.

Jennifer Cantu

Infection Preventionist, Northeast Methodist Hospital/Methodist Healthcare System/HCA

Jennifer Cantu, MSN, RN, is an Infection Preventionist with 4 years of experience and more than 30 years of nursing practice in the acute care hospital setting. Her professional background includes bedside, leadership and quality roles. Prior to her current role, she was a Sepsis Program Coordinator and utilized data analysis and process improvement to improve patient outcomes. Jennifer is passionate about forming collaborative relationships among all healthcare team members to promote a consistent culture of safety focused on “every patient every time.” She is equally committed to mentoring and educating with the overarching belief that knowledge-sharing and support are key to a strong clinical care team.

Roger Stienecker

Medical Director for Clinical Care Reliabilty--Growth Markets, Parkview Health

Roger Scott Stienecker MD FACP FSHEA FIDSA is a graduate of The Ohio State University School of Medicine with Internal Medicine Residency at Wake Forest University then fellowship in Infectious Diseases at Emory School of Medicine. After 22 years in private practice seeing over 27,000 unique patients, he pursued hospital epidemiology with a desire to better serve population health. Starting 2012, he became the Medical Director of Epidemiology Infection Prevention, Antimicrobial Stewardship, and Infectious Diseases Clinical Trials for Parkview Health System. The department has 25+ members in IP, epidemiology and data analytics. Parkview Health is a 1284 bed, 15 hospital system, plus several affiliated hospitals. As of January 2026, he assumed responsibility to provide Infection Prevention and Stewardship services to the affiliated hospitals as the Medical Director for Clinical Care Reliability--Growth Markets. He is on the planning committee for Association for Professionals of Infection Control and Epidemiology (APIC) national meeting.