Surfaces near patients with C. auris commonly re-contaminated within hours of cleaning
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Sansom S, et al. Abstract 50. Presented at: Society for Healthcare Epidemiology of America Spring Meeting; April 12-14, 2022 (hybrid meeting).
Room surfaces near patients colonized with Candida auris were commonly re-contaminated within hours of cleaning or disinfection, according to findings presented at the Society for Healthcare Epidemiology of America Spring Meeting.
The CDC has been warning health care facilities about the emergence of C. auris — the first Candida species to show resistance to all three major classes of antifungals — for almost 6 years. One outbreak in Southern California spread to nine facilities from a single introduction.
“Infections are associated with high morbidity and mortality,” Sarah Sansom, DO, MS, assistant professor of infectious diseases at Rush Medical College and attending physician in infectious diseases at Rush University Medical Center, told Healio. “We have seen most infections with this organism in our high-risk populations, such as those living in nursing homes. Environmental contamination is one route that we think C. auris can be spread in health care facilities.”
To gather additional data to help inform environmental cleaning recommendations and reduce the spread of C. auris, Sansom and colleagues conducted a prospective study of environmental contamination associated with C. auris colonization among patients and residents of four long-term care facilities and one acute-care hospital in Chicago and Irvine, California.
They collected samples from participants’ body sites and the surfaces around them before their rooms were cleaned and disinfected, followed by the targeted cleaning of high-touch surfaces using hydrogen peroxide wipes. They collected samples from the high-touch surfaces immediately after cleaning and every 4 hours for up to 12 hours.
C. auris colonization was most common in the nares (72%) and palms/fingertips (72%) of patients, and co-colonization of body sites with other multidrug-resistant organisms was common, Sansom and colleagues reported.
The surfaces located close to the patient that were commonly re-contaminated with C. auris within 4 hours after cleaning included overbed tables (24%), bed handrails (24%) and remote and call buttons (19%), they found. Re-contamination was rare on surfaces outside of a patient’s room, found in only one out of 120 swabs.
Additionally, the researchers found that environmental co-contamination was more common with resistant gram-positive organisms such as MRSA and vancomycin-resistant Enterococcus than resistant gram-negative organisms.
“More frequent cleaning of environmental surfaces is unlikely to control C. auris environmental contamination,” Sansom said. “Our results suggest that we need to explore other approaches to C. auris control.”
She said the researchers are “evaluating clinical risk factors that may influence increased environmental contamination” and that “long-acting disinfectants or interventions focused on reducing the bioburden of C. auris on patients’ skin are also considerations for our future studies.”
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Sansom S, et al. Abstract 50. Presented at: Society for Healthcare Epidemiology of America Spring Meeting; April 12-14, 2022 (hybrid meeting).
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