December 28, 2023
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Key takeaways:
- Contamination of health care environments near patients with C. auris occurs very quickly, often within 4 hours.
- Most C. auris carriers were co-colonized with at least one bacterial multidrug-resistant organism.
Contamination of the health care environments near patients who are colonized with Candida auris often occurs within 4 hours, researchers found.
“Candida auris is an emerging fungal infection that can spread in health care facilities. We suspect that environmental contamination plays an important role in the transmission of Candida auris in health care facilities,” Sarah E. Sansom DO, MS, assistant professor in the division of infectious diseases at Rush University Medical Center, told Healio.
Contamination of the health care environments around patients colonized with Candida auris happens quickly — often within 4 hours after disinfection took place — researchers said. Image: Adobe Stock.
“We designed this study to understand how quickly Candida auris contaminates the environment near colonized patients, and to identify risk factors for more contamination of the environment,” she said.
Sansom and colleagues conducted a prospective multicenter study of environmental contamination associated with C. auris colonization at six ventilator-capable skilled nursing facilities and one acute-care hospital in Illinois and California.
According to the study, known C. auris carriers were sampled at five body sites — axilla, inguinal crease, nares, palms and fingertips, perianal skin — followed by sampling of nearby room surfaces before disinfection and at 0, 4, 8 and 12 hours after disinfection. Samples were then cultured for C. auris and bacterial multidrug-resistant organisms (MDROs).
The study showed that among the 41 known C. auris carriers, colonization was detected most frequently on palms/fingertips (76%) and nares (71%), whereas C. auris contamination was detected on 32.2% (66/205) of room surfaces before disinfection and 20.5% (39/190) of room surfaces by 4 hours after disinfection.
The researchers said that they found a higher number of C. auris-colonized body sites was associated with higher odds of environmental contamination at each of the measured time points after disinfection.
The study also showed that 38 (93%) of the patients colonized with C. auris were co-colonized with bacterial MDRO, including MRSA (51%), vancomycin-resistant Enterococcus (61%), extended-spectrum beta-lactamase-producing Enterobacterales (68%) and carbapenem-resistant Enterobacterales (41%).
In these patient rooms, 2% to 24% of surfaces were also contaminated with the same MDRO 4 hours after disinfection.
“C. auris rapidly contaminates the health care environment near colonized patients, often together with other multidrug-resistant pathogens,” Sansom said. “Our findings highlight the critical need for broadly effective interventions to reduce colonization burden and environmental contamination against multiple pathogens simultaneously.”
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Sources/Disclosures
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Disclosures:
Sansom reports receiving grants or contracts paid to her institution from the NIH and the Cohn Fellowship Intramural Career Development Grant. Please see the study for all other authors’ relevant financial disclosures.
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