What We Can Learn from Candida auris Outbreak

By Rosie Lyles, MD, MHA, MSc, FACA | 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, MHA, MSc, FACA

Director of Clinicial Affairs

Rosie Lyles, MD, MHA, MSc, FACA is the director of clinical affairs at Medline. She serves as the infectious disease expert and primary medical lead for numerous healthcare businesses, while developing complex clinical strategies and supporting the product life cycle to post market and clinical follow-up. With over a decade of experience investigating healthcare associated infections (HAIs) with a particular focus on hospital epidemiology and prevention of multidrug-resistant organisms (MDROs) infections across the continuum of care, Dr. Lyles has led breakthrough clinical research, changing national guidelines and recommendations that improved patient care and outcomes for the Centers of Disease Control and Prevention (CDC) and the Chicago Prevention and Intervention 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 (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). Dr. Lyles is a Board Member for the US Department of Veterans Affairs on the Health Services Research & Development Scientific Merit and for the White House Coronavirus (COVID-19) Commission for Safety and Quality for Nursing Homes, served as Medical Advisory Board for C. Diff Foundation, Co-Chairman of the Association for Health Care Environment (AHE) Industry Advisory Council, an Infectious Diseases Expert for the Florida Health Care Association, and participated in White House Forum on Antibiotic Stewardship (2015) for the National Action Plan for Combating Antibiotic-Resistant Bacteria.

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