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Clinical Alert: Preventing the Spread of Candida auris

The US Centers for Disease Control and Prevention (CDC) has received reports from international healthcare facilities that Candida auris (C. auris), an emerging multidrug-resistant (MDR) yeast, is causing invasive healthcare-associated infections with high mortality.1 Given the occurrence of C. auris in nine countries on four continents since 2009, the CDC released a clinical alert on June 24, 2016 calling for U.S. healthcare facilities to be on the lookout for C. auris in patients.The EPA is working with the CDC to provide updates on the eligibility of hospital disinfectants.

Background Information on Candida auris1:

  • C. auris is an emerging multidrug-resistant (MDR) yeast that can cause invasive infections and is associated with high mortality.
  • C. auris was first described in 2009 after being isolated from external ear discharge of a patient in Japan.
  • C. auris infections have most commonly been hospital-acquired and occurred several weeks into a patient’s hospital stay.
  • Patients were found to have similar risk factors for infections with other Candida species, including: diabetes mellitus, recent surgery, recent antibiotics, and presence of central venous catheters.
  • At least two countries have described healthcare outbreaks of C. auris infection and colonization involving more than 30 patients each. 
  • The precise mode of transmission within the healthcare facility is not known; however, experience during these outbreaks suggests that C. auris might contaminate the environment of rooms of colonized or infected patients.

CDC Interim Prevention and Control Recommendations for Hospitalized Patients with C. auris:

The CDC has issued interim guidance on how healthcare facilities can respond to suspected cases of C. auris. There is NO CHANGE in current infection prevention practices for hand hygiene.

Environmental Infection Control Recommendations1:

  • Reporting – Healthcare facilities who suspect they have a patient with C. auris infection should contact state/local public health authorities and CDC (candidaauris@cdc.gov)
  • Infection Control – Until further information is available, healthcare facilities should place patients with C. auris colonization or infection in single rooms and healthcare personnel should use Standard and Contact Precautions. In addition, state or local health authorities and CDC should be consulted about the need for additional interventions to prevent transmission. CDC is working with domestic and international partners to develop definitive infection control guidance.
  • Environmental Cleaning – Anecdotal reports have suggested that C. auris may persist in the environment. Healthcare facilities who have patients with C. auris infection or colonization should ensure thorough daily and terminal cleaning and disinfection of these patient’s rooms. The hospital-grade disinfectant may fulfill the baseline fungal (fungicidal) disinfection requirements by using Trichophyton mentagrophytes. (Details may be found in 810.2200 EPA Guidelines).

PDI offers Sani-Cloth® Bleach Germicidal Disposable Wipes (4-minute contact time) and Sani-Cloth HB Germicidal Disposable Wipes (10 minute contact time) for environmental surface disinfection with known or suspected Candida auris contamination. Both products meet the most current recommendations provided by the CDC and EPA. These updated interim guidelines for environmental disinfection supersede the CDC guidelines posted earlier on www.cdc.gov.

 

If you have any additional questions, please contact PDI at (800) 999-6423.

 

1 "Globabl Emergence of Invasive Infections Caused by Multidrug-Resistant Yeast Candida Auris." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 24 June 206. Web. 06 Sept. 2016.