Since the first cases were identified in the United States just a few years ago, Candida auris has fueled concern over the threat of antibiotic resistances and healthcare-associated infections.
C. auris is a particularly worrisome fungal infection as it is resistant to all three classes of antifungal drugs, environmentally hardy, and transmissible between people.
On February 16, 2017 the Centers for Disease Control and Prevention (CDC) noted roughly 35 cases in the United States. Within this web page though, there is also a hidden gem regarding environmental disinfection. Triggered by the rise of C. auris, the CDC released new recommendations for the use of hospital-grade disinfectants effective against Clostridium difficile.
The recommendations for patients infected or colonized with C. auris are Contact Precautions; however, unlike many organisms requiring these precautions, this infection requires special environmental cleaning guidance. Organisms, such as C. auris and C. difficile, which have a tendency to persist in the environment often require special disinfectants. The CDC recommends the use of an EPA-registered hospital-grade disinfectant that is effective against C. difficile. Although healthcare facilities are expected to carry this type of product for daily and terminal cleaning practices, it can often be challenging for daily use by healthcare staff for tools like stethoscopes, etc. One of the most helpful products for immediate cleaning has been germicidal wipes. As an infection preventionist, these have made a huge difference for ease of use and staff compliance, and by this I mean not environmental service staff, but rather those on the units that need to wipe down a computer-on-wheels or examination table.
Clorox Healthcare is among many companies to manufacture a germicidal wipe; however, the EPA just registered Clorox's Healthcare Bleach Wipe as effective against 58 organisms with a three-minute wet time. Even better, it’s effective against C. difficile spores, which is a serious issue in the United States. C. difficile alone infects roughly 250,000 people and is responsible for 14,000 deaths per year. The development of stronger products, such as Clorox’s bleach wipes, is beneficial for prevention against difficult organisms, like C. difficile; particularly in outpatient environments. Reports have shown an increasing frequency of community-associated C-difficile infections. A majority of these patients had outpatient visits following their diagnosis. This means that the risk for transmission is even higher as outpatient facilities are often challenged in terms of rigorous disinfection between patients. A germicidal wipe that is effective against a wide range of organisms and allows for easy use is pivotal to stopping transmission within the outpatient healthcare population.
Disinfection is challenging in the healthcare world, not just because there are millions of tiny surfaces and objects, but also because certain organisms require a little extra strength. The rise of resistant and emerging organisms like C. auris points to the need for easier disinfection practices within healthcare, especially in terms of those products that are used frequently by the healthcare staff themselves. Even the shorter dry times for these products have made a difference because as so many of us know, a minute in a hospital can feel like a lifetime. As new organisms are identified and existing ones become resistant to antimicrobials, the availability of strong disinfecting products has become even more pivotal.
Saskia v. Popescu, MPH, MA, CIC, is a hospital epidemiologist and infection preventionist with Phoenix Children's Hospital. During her work as an infection preventionist she performed surveillance for infectious diseases, preparedness, and Ebola-response practices. She is currently a PhD candidate in Biodefense at George Mason University where her research focuses on the role of infection prevention in facilitating global health security efforts. She is certified in Infection Control.
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