Healthcare Hygiene magazine October 2019 | Page 19
patients with C. auris infections that were admitted to
the University of Chicago Medicine (UCM). In their study,
the researchers collected environmental samples to assess
environmental contamination before and after cleaning.
They sampled the following surfaces: Bathroom sink drain,
bedside table, bedrail, mattress, chair and window ledge.
Routine terminal cleaning included using a 10 percent so-
dium hypochlorite solution that was applied to high-touch
surfaces of the patient room and bathroom. The enhanced
terminal cleaning process also included removing and
replacing privacy curtains, using a single UV disinfection
cycle in the room and bathroom, as well as supervision
of the process by the environmental services manager.
The researchers note that due to a delay in identification
of C auris for the first patient, pre-cleaning samples were
taken more than two weeks after the patient had been
discharged. During the intervening weeks, multiple patients
had occupied the room and there had been more than
three routine terminal cleanings. None of these samples
was positive for C auris. Pre-cleaning, in-residence sam-
ples indicated C auris contamination of multiple surfaces
for the second patient. Because of transfers within the
institution, there are three sets of post-cleaning cultures
for the second patient. All post-cleaning environmental
cultures were negative for both patients. The researchers
concluded that while routine terminal cleaning may have
been effective in removing C auris from surfaces in one
patient’s room, the enhanced terminal cleaning strategy
used here was effective in their facility.
In their study, Kean, et al. (2018) evaluated a panel of
C. auris clinical isolates on different surface environments
against the standard disinfectant sodium hypochlorite and
high-level disinfectant peracetic acid. The researchers note
that, “C. auris was shown to selectively tolerate clinically rele-
vant concentrations of sodium hypochlorite and peracetic acid
in a surface-dependent manner, which may explain its ability
to successfully persist within the hospital environment.”
The implications for infection control are significant,
and Kean, et al. (2018) add that, “Understanding the
mechanisms of spread and survival of this pathogen in the
hospital environment is therefore crucial, particularly as it
may persist on plastics and steel, and survive as biofilms.
Several recent investigations have confirmed that C. auris
is capable of prolonged survival on surfaces and have
shown that surface disinfection protocols have variable
and unsatisfactory outcomes. Since it has been shown
recently that 1,000 ppm of an active chlorine solution is
highly effective against these organisms when tested in
suspension, the interaction between the pathogen and
surfaces is likely to be important in determining survival of
C. auris in the hospital environment. Our own work confirms
this, with C. auris biofilms being generally insensitive to a
range of key antimicrobial agents, thus prolonging their
survival capacity.”
This article (with references) continues online, visit: https://www.healthcarehygienemagazine.com/microbiology/
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