To assess preparedness for Candida auris in Canadian hospitals.

Cross-sectional survey.

Canadian Nosocomial Infection Surveillance Program (CNISP) hospitals.

In June 2024, surveys were e-mailed to the infection prevention and control departments of 109 CNISP hospitals and their 33 microbiology laboratories. The surveys assessed policies for patient screening/management and laboratory processes supporting C. auris transmission prevention. Results were compared to a similar 2018 survey.

All 109 hospitals and 32/33 laboratories responded. Most hospitals had policies for admission screening (80%, 87/109) and policies/defined plans for post-exposure screening (95%, 104/109). Policy presence increased from 18% to 73% in 56 hospitals completing both 2018 and 2024 surveys (P < 0.001). Among hospitals with admission screening policies, 69% (60/87) screened for recent out-of-country hospitalization. All but one hospital implemented transmission-based precautions for cases; 70% (76/109) continued precautions indefinitely. Overall, 94% (99/105; excluding hospitals with exclusively private rooms) and 55% (60/109) of hospitals screened roommates and wardmates, respectively. Frequency and timing of screening and policies regarding precautions for exposed patients varied. All hospitals used axilla and groin swabs, at minimum, for screening. Most (81%, 26/32) laboratories identified all clinically significant Candida isolates to species level, increasing from 48% to 85% (P < 0.001) in the 27 laboratories completing both 2018 and 2024 surveys. Twenty-four laboratories (75%) had standard operating procedures for processing screening specimens; 96% (23/24) used direct plating onto chromogenic agar.

Despite progress in C. auris preparedness, areas for improvement remain. Variability in practice may be related to evidence gaps and resource constraints.

Influenza can be introduced and propagated in healthcare settings by healthcare workers (HCWs) working while ill with influenza. However, reasons driving this behavior are unclear. In this study, we examined barriers to and facilitators of absenteeism during the influenza season.

Cross-sectional mixed methods study.

Ambulatory and inpatient settings in a large, tertiary-care healthcare system.

An anonymous electronic survey was sent to HCWs between June 11 and July 13, 2018, asking participants to self-report influenza-like illness (ie, ILI symptoms of fever, chills, cough, or sore throat) during the 2017–2018 influenza season. We conducted a logistical regression analysis to identify factors associated with absenteeism.

Of 14,250 HCWs, 17% responded to the survey. Although 1,180 respondents (51%) reported symptoms of ILI, 575 (43%) did not stay home while ill. The most commonly perceived barriers to ILI absenteeism included being understaffed (odds ratio [OR], 1.78; P = .04), unable to find a replacement for work (OR, 2.26; P = .03), desiring not to use time off (OR, 2.25; P = .003), and paid by the hour or unable to afford being absent (OR, 2.05; P = .02). Common perceived facilitators of absenteeism included support from coworkers and management, clearer policy, better sick days availability, and lower perceived threat of disciplinary action.

Reporting to work with ILI symptoms is common among HCWs. Most barriers and facilitators are related to systems. Addressing system factors, such as policies regarding sick days and sick leave and ensuring adequate backup staffing, is likely to facilitate absenteeism among ill HCWs.