COVID-19 has consumed the focus of cleaning efforts in healthcare facilities, but the threat of superbugs remains--especially for those already exposed to the SARS-CoV-2 virus.
The Spread of Candida Auris Among COVID-19 Patients Raises Concerns Regarding PPE Use and Cleaning Consistency
Prior to the outbreak of SARS-CoV-2, the prevalence and spread of antibiotic-resistant superbugs in healthcare facilities across the U.S. was a major concern.
Antibiotic-resistant superbugs result in millions of infections and tens of thousands of deaths in the U.S. each year.
According the CDC, antibiotic-resistant bacteria and fungi are responsible for more than 2.8 million infections and 35,000 deaths in the United States each year.
Putting this into perspective, on average someone in the United States gets an antibiotic-resistant infection every 11 seconds and someone dies from an antibiotic-resistant infection every 15 minutes.
When Clostridioides difficile (C. diff) is added to the statistics, the numbers increase to 3 million infections a year and about 48,000 deaths.
A recent outbreak of the antibiotic-resistant fungus C. auris has been observed around the world, with approximately 1,500 cases being reported to the U.S. Centers for Disease Control and Prevention.
One such case originated in the COVID-19 ward of a Florida healthcare facility where 42 of 67 patients tested positive for C. auris, which may have potentially contributed to the deaths of 8 individuals within 30 days of screening.
Primary reasons cited by investigators for the spread were:
- Healthcare providers using multiple gown and glove layers in the COVID-19 unit.
- Extended use of the underlayer of PPE.
- Lapses in cleaning and disinfection of shared medical equipment and mobile computers, and;
- Lapses in adherence to hand hygiene.
After implementing the following solutions:
- Removal of supplies from hallways,
- Implementation of enhanced cleaning and disinfection practices, and;
- Ending base PPE layer practices,
the hospital involved in the investigation reported no further outbreaks of C. auris.
Infection Prevention and Control for Candida Auris
C. auris--first discovered in Japan in 2009--is a multi-drug resistant fungus that causes severe bloodstream, wound, and inner ear infections, most commonly among patients
- Who have been in the hospital for a long time,
- Have a central venous catheter, or other lines or tubes entering their body, or;
- Have previously received antibiotics or antifungal medications.
The infection is reportedly difficult to detect--often resulting in misdiagnosis--which has contributed to a death rate of more than 1 in 3 patients once they are infected.
Preventative measures, such as those implemented in the Florida healthcare facility in the previously cited 2020 investigation, include:
- Advanced hand hygiene, which includes thoroughly washing hands with soap and water, completely drying hands with a clean paper towel, keeping fingernails cut short and clean, cleaning under jewelry, avoiding the use of fake fingernails, wearing gloves when necessary and appropriate, and avoiding direct contact with potentially contaminated surfaces without washing your hands immediately after.
- Implementing contact precautions, such as spatial separation of patients, partitions between patients, and routine HPC PPE changeouts, and;
- Enhanced environmental cleaning and terminal disinfection of patient rooms, medical equipment, and partitions on a daily basis, as well as whenever a patient is moved or discharged from the room, using a combination of EPA-registered commercial detergents to remove any visible soil, hospital-grade disinfectants to kill the fungus and any other pathogens or bacteria, and UVC disinfection lights to inhibit growth while the room is unoccupied.
References & Resources
- Candida auris Outbreak in a COVID-19 Specialty Care Unit — Florida, July–August 2020
- Superbug Outbreak Tied to Improper Sanitation and PPE Practices
- General Information about Candida auris
- Hand Hygiene in Healthcare Settings
- Candida auris: A Drug-resistant Germ That Spreads in Healthcare Facilities
- Infection Prevention and Control for Candida auris
The rush to end the spread of SARS-CoV-2 has resulted in documented issues with overzealous behaviors, such as the donning of multiple layers of PPE in healthcare settings resulting in the spread of deadly antibiotic-resistant strains of fungus and bacteria, which were previously on the decline in healthcare faculties.
Additional oversights, such as lapses in enhanced cleaning and advanced hand hygiene by healthcare practitioners, have contributed to further preventable patient health challenges.
Outsourcing patient room cleaning, terminal disinfection, and surgery room cleaning and disinfection can free up hospital staff to focus on patient care and preventative hygiene practices.
Contact us today and discover why Vanguard Cleaning Systems® is the Standard of Clean® for businesses throughout Northwest Arkansas, Missouri, and Oklahoma.
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