Fungal carriage on healthcare workers’ hands, clothing, stethoscopes and electronic devices during routine patient care: a study from a tertiary care center

Background – Invasive fungal infections are a constant threat to immunocompromised and critically ill patients. Healthcare workers caring for such patients act as conduits of transmission through their contaminated hands and belongings. Although bacterial contamination of healthcare workers is known, our knowledge about fungal carriage is sparse. Aim– To study the prevalence and type of fungal carriage on healthcare workers hands, aprons/hospital scrubs, electronic devices and stethoscopes. Methods– Healthcare workers working in Medicine ward and ICU during November and December 2019 were sampled. Hand washes were collected in Brain Heart Infusion (BHI) broth with gentamycin. Direct impression smears on blood agar were taken from aprons/hospital scrubs. Electronic devices and stethoscopes were sampled using moist cotton swabs. Subculture and plating was done on Sabarouds Dextrose Agar (SDA). Yeasts were identified using Matrix Assisted Laser Desorption Ionisation Time of Flight (MALDI TOF) and moulds were identified using microscopy. Findings – Out of 60 health care workers, 20 (33.3%) had fungal carriage. Aprons/hospital scrubs and hands were contaminated in 17 (28.3%) and 3 (5%) respectively. Aprons/hospital scrubs mainly constituted moulds belonging to species of Aspergillus. Hands were contaminated with Candida tropicalis, Candida parapsilosis and Candida auris. Electronic devices and stethoscopes had no fungal contamination. Sex (p=0.77), designation (p=0.32) and unit of surveillance (p=0.06) were not significantly associated with fungal isolation from health care workers. Conclusion – Active fungal surveillance provides prevalent carriage rates and serve as a feedback to improve our disinfection and hand hygiene practices. It also aids in identification of potential source of hospital outbreaks