What We Can Learn from Candida auris Outbreak

By Rosie Lyles, MD, MHA, MSc | June 26, 2018

In May, I attended the Centers for Disease Control and Prevention’s advisory committee for infection control. From there, along with weekly monitoring, I am now hyper aware of the next emerging deadly pathogen: Candida auris. This fungus is considered to be a serious global threat because it’s multidrug-resistant, can only be identified in specialized labs and is already causing outbreaks in healthcare settings.

But what I took away from the presentation could be applied to many of the outbreaks healthcare systems have tackled and will continue to deal with when it comes to infection prevention.¹

Review environmental disinfection

In the hospital, the obvious places where C. auris cultures existed include the bed rails, sheets and chairs. Cultures were also found on shoes, the temperature probe and even the hand sanitizer dispenser. Bleach germicidal cleansers, hydrogen peroxide and cleansers with 10 percent sodium hypochlorite all performed well in killing C. auris on surfaces. The CDC even recommended preemptively disinfecting in common areas as all long-term care facilities with ventilated patients.

Pull together your PPE

As we go through our daily responsibilities, it can feel like we’re simply going through the motions and we often forget the importance of personal protective equipment. Gowns, gloves and masks can prevent or even stop cross contamination. We shouldn’t wait for outbreaks to implement PPE protocols. Hospitals and long-term care facilities should think ahead and be prepared.

Decolonization

Another point the CDC made was about decolonization. If you decolonize a patient with C. auris with an antiseptic such as chlorhexidine gluconate (CHG), you actually stop cross transmission from the patient to the environment, as well as healthcare workers.² Clinicians need to remember proper antibiotic stewardship and consider using topical antiseptics to reduce body surface bacteria to prevent carriage and infections.

Reserve rooms

During the Ebola outbreak, there was no stronger realization, based on the fear healthcare professionals felt, for the need to always have reserved rooms for infected patients. Same goes for C. auris patients based on recommendations from the CDC. Colonization is said to happen for months prior to the organism being detected increasing transmission.

Vigilant infection prevention practices

C. auris may be the next emerging outbreak that hospitals and nursing homes are faced with, but the proper infection prevention practices should carry through from previous infectious events. Remain vigilant. That awareness helps any facility stay prepared.

Are you implementing solutions that are grounded in best practice to help support your infection prevention plans?

Sources:

1. Snigdha Vallabhaneni, MD, MPH. Candida auris Update. CDC Mycotic Diseases Branch. May 2018.

2. Schelenz, Federation of Infection Societies Poster, 2017.

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Rosie Lyles, MD

Director of Clinical Affairs

Rosie Lyles, MD, MHA, MSc is the director of clinical affairs at Medline. She was previously the head of clinical affairs at Clorox Healthcare where she served as the medical/clinical expert and primary medical science liaison for three healthcare businesses, supporting all scientific research, as well as clinical and product intervention design and development. Lyles has more than a decade of experience investigating hospital-associated infections (HAIs) with a particular focus on the epidemiology and prevention of multidrug-resistant organisms such as C. difficile, MRSA and CRE infections in acute care hospitals and long-term acute care hospitals as a physician-researcher at Cook County Health and Hospitals System. Lyles has also directed numerous clinical studies and interventions for the CDC and the Chicago Antimicrobial Resistance and Infection Prevention Epicenter with numerous authored peer-reviewed journal articles related to infectious disease epidemiology. She is an active member of the Infectious Disease Society of America, Association for Healthcare Environment and the Society for Healthcare Epidemiology of America. Currently she serves as a grant reviewer for the National Institutes of Health/National Institute of Allergy and Infectious Diseases (NIH / NIAID), manuscript reviewer for New England Journal of Medicine, American Journal of Infection Control, medical reviewer for U.S. Department of Veterans Affairs for HSR&D Scientific Merit Board, and Medical Advisory Board for C. Diff Foundation. Rosie received her medical degree from St. Matthew's University School of Medicine and completed a master's in Health Service Administration at St. Joseph College and a master's of Science in Clinical Research and Translational Sciences at the University of Illinois at Chicago.

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