Healthcare Hygiene magazine September 2021 September 2021 | Page 49

• We now understand that Candida auris , a very dangerous emerging pathogen , can be transmitted easily from patient-to-patient , with the healthcare environment as a key vector .
read label claims and follow all manufacturer ’ s instructions for use , including applying the product for the correct contact time .
No-touch technologies such as vaporized hydrogen peroxide or germicidal UV irradiation are increasingly integrated into terminal cleaning processes . 11 While there is limited research about the efficacy of these technologies specifically against C . auris , they may be an adjunct to routine cleaning and disinfection processes . Decontamination with 35 percent hydrogen peroxide vapor was deployed as part of a range of measures to successfully control a C . auris outbreak in a European hospital . 12 In laboratory testing , Candida auris and two other Candida species were significantly less susceptible to killing by UV-C than MRSA . 13
Standardize protocols .
The CDC C . auris guidelines recommend meticulous attention to daily and terminal cleaning / disinfection of all patient rooms , all areas where they receive care , and all shared equipment . C . auris has been cultured from many locations in patient rooms , including high touch surfaces and general environmental surfaces such as windowsills . Shared equipment such as glucometers , blood pressure cuffs and nursing carts have also been found to be contaminated with C . auris . 4
Monitor Adherence and Provide Feedback .
Disinfectants are only effective when consistently and correctly applied . Objective monitoring and feedback on the thoroughness of cleaning using objective methods such as fluorescent markers are essential to ensure that critical surfaces and equipment have been disinfected . The CDC C . auris guidelines recommend increased environmental hygiene monitoring when there is a patient with known / suspected C . auris in the facility . 4 Environmental hygiene monitoring data must be shared with staff and leadership to drive continuous improvement . For more information on evaluating environmental cleaning , review the CDC Toolkit : Options for Evaluating Environmental Cleaning . 14
We now understand that Candida auris , a very dangerous emerging pathogen , can be transmitted easily from patient-to-patient , with the healthcare environment as a key vector . Once again , environmental hygiene plays a central role in preventing transmission of this emerging infection . The CDC has published recommendations for infection prevention for Candida auris , including the use of disinfectants that are effective against C . auris and increased environmental hygiene monitoring to ensure cleanliness . These pathogen-specific recommendations dovetail into previously published Core Components of Environmental Cleaning and Disinfection in Hospitals .
Linda Homan , RN , BSN , CIC , is senior manager of clinical affairs for Ecolab .
References :
1 . Satoh K , Makimura K , Hasumi Y , Nishiyama Y , Uchida K and Yamaguchi H . ( 2009 ). Candida auris sp . nov ., a novel ascomycetous yeast isoated from the external ear canal of an inpatient in a Japanese hospital . Microbiology and Immunology , 41-44 .
2 . Lyman M . ( 2021 ). Notes from the Field : Transmission of Pan-resistant and Echinocandin-resistant Candida auris in healthcare facilities - Texas and the District of Columbia , January-April 2021 . Morbidity and Mortality Weekly Report , 1022-1023 .
3 . Association for Professionals in Infection Control and Epidemiology . July 28 , 2021 . APIC Statement : With resistant C . auris spreading , healthcare facilities must adopt aggressive infection prevention and control measures . Retrieved from Association for Professionals in Infection Control and Epidemiology : https :// apic . org / apic-statement-with-resistant-c-auris-spreading-healthcare-facilities-mustadopt-aggressive-infection-prevention-and-control-measures /
4 . Centers for Disease Control and Prevention . July 19 , 2021 . Infection Prevention and Control for Candida auris . Retrieved from Centers for Disease Control and Prevention : https :// www . cdc . gov / fungal / candida-auris / c-aurisinfection-control . html
5 . Piedrahita C , Cadnum J , Jencson A , Saikh A , Ghannoum M and Donskey C . July 28 , 2017 . Environmental surfaces in healthcare facilities are a potential source for transmission of Candida auris and other Candida species . Infection Control and Hospital Epidemiology , 1107-1109 . Retrieved from Association for Professionals in Infection Control and Epidemiology : https :// apic . org / apic-statement-with-resistant-c-auris-spreading-healthcare-facilities-must-adoptaggressive-infection-prevention-and-control-measures /
6 . Ahmad S and Alfouzan W . ( 2021 ). Candida auris : Epidemiology , diagnosis , pathgenesis , antifungal susceptibility , and infection control measures to combat the spread of infections in healthcare facilities . Microorganisms , 807-832 .
7 . Centers for Disease Control and Prevention . Oct . 13 , 2020 . Reduce Risk from Surfaces : Core Components of Environmental Cleaning and Disinfection in Hospitals . Retrieved from Centers for Diease Control and Prevention : https :// www . cdc . gov / hai / prevent / environment / surfaces . html
8 . Ku T , Walraven C and Lee S . ( 2018 ). Candida auris : Disinfectants and Implications for Infection Control . Frontiers in Microbiology , 1-12 .
9 . United States Environmental Protection Agency . July 21 , 2021 . List P : Antimicrobial products registered with EPA for claims against Candida auris . Retrieved from EPA : https :// www . epa . gov / pesticide-registration / list-p-antimicrobialproducts-registered-epa-claims-against-candida-auris
10 . Cadnum J , Shaikh A , Piedrahita C , et al . ( 2017 ). Effectiveness of disinfectants against Candida auris and other Candida species . Infect Control Hosp Epidemiol . 1240-1243 .
11 . Weber D , Kanamori H and Rutala W . ( 2016 ). No Touch technologies for environmental decontamination . Focus on ultraviolet devices and hydrogen peroxide systems . Current Opinion in Infectious Diseases , 424-31 .
12 . Schelenz S , Hagen F , Rhodes J , Abdolrasouli A , Chowdhary A , Hall A , et al . ( 2016 ). First hospital outbreak of the globally emerging Candida auris in a European hospital . Antimicrobial Resistance and Infection Control , 1-7 .
13 . Cadhum J , Shaikh A , Piedrahita C , Jencson A , Larkin E , Ghannoum M and Donskey , C . ( 2017 ). Relative resistance of emerging fungal pathogen Candida auris and other Candida species to killing by ultraviolet light . Infect Control Hosp Epidemiol . 94-96 .
14 . Centers for Disease Control and Prevention . Oct . 15 , 2010 . Healthcareassociated Infections : Options for Evaluating Environmental Cleaning . Retrieved from Centers for Disease Control and Prevention : https :// www . cdc . gov / hai / toolkits / evaluating-environmental-cleaning . html www . healthcarehygienemagazine . com • september 2021
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