Interventional Care
Under the Microscope with Bill Rutala: Inactivation of Candida auris by germicides.
Susceptibility of Candida auris and Candida albicans to 21 Germicides Used in Healthcare Facilities, authored by Rutala WA, Kanamori H, Gergen MF, Sickbert-Bennett EE, Weber DJ1 addresses the ability of 21 germicides to inactivate C. auris.
Candida auris is an emerging fungal pathogen that is often resistant to major classes of antifungal drugs. It is considered a serious global health threat as it can cause severe infections with frequent mortality in over a dozen countries. There is evidence that it can survive on healthcare environmental surfaces for at least 7 days and cause outbreaks in healthcare facilities. It is clear that infection prevention strategies, such as surface disinfection and hand hygiene, are essential to controlling transmission. There are limited data on the activity of antiseptics and disinfectants used in healthcare to inactivate this pathogen.
There is no standard level of germicidal efficacy for environmental surfaces, but most of the disinfectants tested (10/13, 77%) in this study, which demonstrated at least a 3-log10 reduction in 1 minute, are likely to be clinically effective against C. auris when used appropriately. Water-based quaternary ammonium compounds (QAC), which are commonly used for surface disinfection, had limited activity and therefore should not be used for disinfection of environmental surfaces or noncritical patient equipment in rooms housing patients with C. auris. QAC with alcohol, such as Super Sani-Cloth® Germicidal Disposable Wipes and Sani-Cloth® Prime Germicidal Disposable Wipe were effective against the C. auris AR Bank #0385 strain (3.9 and 4.1-log10 reduction, respectively) with a 1-minute contact time.
The EPA recently announced that products that wish to make a claim against drug-resistant C. auris must submit data using a specified test method and the C. auris strain AR Bank #0385 used in this study. Most antiseptics (7/9, 78%, e.g., 2% and 4% chlorhexidine gluconate [CHG], 0.5% triclosan, 10% povidone-iodine, 1% chloroxylenol, 3% hydrogen peroxide, and 1% CHG with 61% ethyl alcohol) did not achieve a 3-log10 reduction of C. auris in 1 minute. In conclusion, proper disinfection of environmental surfaces using disinfectants effective against C. auris is important to help prevent the spread of C. auris.
Disclosure: Dr. Rutala is a consultant for PDI.
1Rutala WA, Kanamori K, Gergen MF, Sickbert-Bennett EE, Weber DJ. 2019. Susceptibility of Candida auris and Candida albicans to 21 germicides used in healthcare facilities. Infect Control Hosp Epidemiol 40:380-382.
Profile
Dr. Bill Rutala is the Director and co-founder of the Statewide Program for Infection Control and Epidemiology and a Professor for the Division of Infectious Diseases at the University of North Carolina’s School of Medicine. He was the Director of Hospital Epidemiology, Occupational Health and Safety Program at the University of North Carolina Hospitals for 38 years before retiring in May 2017.
He is a retired Colonel with the U.S. Army Reserve and is certified in infection control. He has been an advisor to the Centers for Disease Control and Prevention (a former member of the Healthcare Infection Control Practices Advisory Committee [HICPAC], 1999-2003), the Food and Drug Administration (a former member of the General Hospital and Personal Use Devices Panel), the U.S. Environmental Protection Agency (a member of the Scientific Advisory Panel on Antimicrobial Research Strategies for Disinfectants) and the Federal Trade Commission. Dr. Rutala is a member of various committees on the local, state, national, and international level as well as several professional societies including the American Society for Microbiology, Association for Professionals in Infection Control and Epidemiology (APIC), and the Society of Healthcare Epidemiology of America (SHEA). He has served or currently serves on the three peer-reviewed journals on infection prevention in the world (i.e., Infection Control and Hospital Epidemiology, American Journal of Infection Control, and The Journal of Hospital Infection).
He has more than 650 publications (peer-review articles, books, book chapters, brief reports) in the fields of disinfection and sterilization (to include several guidelines such as the CDC Guideline for Disinfection and Sterilization in Healthcare Facilities) and epidemiology and prevention of healthcare-associated infections. Dr. Rutala has also been an invited lecturer at over 400 states, national and international conferences (in over 40 states and 40 countries) and has testified twice before the U.S. Congress. Dr. Rutala earned his Bachelor of Science degree in science from Rutgers University, his master’s degree in microbiology from the University of Tennessee, and both his master’s in public health and a doctorate in microbiology from the University of North Carolina School of Public Health.
His contributions to infection prevention have been acknowledged by professional organizations with the following awards: Carole M. DeMille Lifetime Achievement Award (APIC, 1999), Lowbury Lecture (Healthcare Infection Society, Scotland, 2002), Hygiene Medal (Rudolf Schulke Foundation, Germany, 2013), Larson Lectureship Award (APIC, 2012), SHEA Lectureship (SHEA, 2012), Barr Distinguished Alumni Award (UNC School of Public Health, 2012), Kelsey Lecture (the United Kingdom, 2001 and 2012), Crawford Award (lifetime achievement, OSAP, 2008), and Favero Lectureship (APIC, 2009). Dr. Rutala has a “named” award in his honor from two international infection prevention professional societies …APIC (William A. Rutala Research Award) and SHEA (William A. Rutala Scholarship).