How to Protect your Healthcare Facility Against Candida auris
Candida auris, is a highly contagious infection, rapidly spreading throughout healthcare facilities on the East Coast. Candida auris is dangerous because it is easily spread, survives on surfaces for months, can be multi-drug resistant, and is difficult to detect so it is often misdiagnosed.
As the director of EVS, keeping your guests and patients healthy and safe is a top priority.
With the recent emergence of Candida auris, cleaning and disinfecting with the proper commercial cleaning supplies is important in controlling the spread of this deadly pathogen. Cleaning for C. auris does not just mean increasing the frequency your facility is cleaned throughout the day but ensuring you are using the right combination of chemicals and procedures.
How is Candida auris spread?
Candida auris spreads through person to person or person to surface contact.
Pro Tip: Candida auris can survive on hard or soft surfaces.
The CDC does not know the exact timeframe which C. auris can be contagious, but they have found it can survive on surfaces and humans for several months.
Cauris is most dangerous to people who have compromised immune systems such as hospital patients, long-term care patients, people with intravenous tubes, or those who have recently had a fungal infection. The Center for Disease Control (CDC) found that 30 - 60% of patients who get candida auris die.
The CDC reports that as of March 2019, there have been over 600 reported clinical cases of C. auris, primarily in New York and New Jersey.
The best way to protect your healthcare facility and keep your patients safe is by trying to identify and isolate patients who may be carrying C. auris, and by implementing cleaning and disinfecting procedures.
Cleaning and disinfecting for hard and soft surfaces requires two different procedures.
Cleaning and Disinfecting HARD Surfaces to Prevent the Spread of Candida auris
Cleaning and disinfecting hard surfaces will kill and remove Candida auris spores, reducing the likelihood of your patients becoming infected.
For disinfectants to be effective, the surface must first be cleaned.
Pro Tip: Always Clean Before you Disinfect. It is important to clean or remove any visible soils before disinfecting. Cleaning removes loose soils, preparing the surface or object to be disinfected.
Disinfecting kills germs on the surface, preventing them from spreading. If a surface is not cleaned first, germs can hide under soils and reduce the efficacy of the disinfectant. Leaving germs behind means leaving your patients at risk of illness.
Always remember to begin any cleaning procedure with the proper personal protective equipment.
When cleaning and disinfecting for Candida auris, we recommend the use of:
- Breathing Masks
Use a multi-purpose surface cleaner or cleaner/disinfectant to wipe down and remove any visible mucus or soil.
Apply a disinfectant to areas where the infection may be present.
What type of disinfectant is effective against (kills) Candida auris?
Candida auris was first recognized as a pathogen in 2009, but has not been a global health threat until recently, so commercial cleaning products do not currently have an EPA registered kill claim against Candida auris.
The CDC recommends EPA List K products, or Clorox bleach wipes and sprays, Clorox Healthcare Hydrogen Peroxide, Super Sani-Cloth ®, Prime Sani-Cloth ®, or Oxivir ® TB Wipes to disinfect surfaces with Candida auris.
Pro Tip: Quaternary ammonium compounds, a common disinfectant in many facilities, has not been proven effective against C. auris.
Adhere to the manufacturer’s guidelines (or the product label) for the recommended wet dwell time for disinfection.
If you do not let the disinfectant dwell for the recommended wet dwell time the product is not going to be effective at killing the germs. Without proper elimination of germs, they will continue to replicate and spread, increasing the chance of illness throughout your facility.
When to disinfect?
To prevent the spread of C. auris, facilities will require daily and terminal cleaning and disinfecting.
Pro Tip: Terminal cleaning is done in healthcare facilities to control and prevent the spread of hospital-acquired infections. Terminal cleaning involves cleaning and disinfecting all objects and areas in a patient room including: detachable objects, ceiling lights, fans, air ducts, floors, and any other surfaces.
All high touch point surfaces should be disinfected multiple times a day.
Common areas where Candida auris may be present should be cleaned and disinfected at least once a day.
In addition to frequent daily disinfection of surfaces, terminal cleaning should be performed:
- After a patient has been discharged from a room
- Prior to a new patient entering a room
- Following a renovation
Where to disinfect?
C. auris is not limited to any type of surface or area.
High-touch surfaces to disinfect daily:
- Nursing Stations
- Nursing Carts
- Bed Rails
- Any Reusable Equipment or Machines
- Meal Trays/Carts
Surfaces to disinfect when terminal cleaning:
- Detachable objects in the room such as:
- IV equipment
- hospital beds
- bedside tables
- Ceiling fans
- Air Ducts
- Window Sills
Cleaning SOFT Surfaces to Prevent the Spread of Candida auris
Soft surfaces cannot be fully disinfected because of the chemical’s inability to fully penetrate the porous surface.
Soft surfaces present a cleaning challenge because they cannot be fully disinfected, can be damaged by disinfectants, and may not be able to be laundered as frequently as hard surfaces can be disinfected.
In addition, soft surfaces are often overlooked and not cleaned as frequently as they should be. The typical requirement for facilities is to clean soft surfaces only when they are visibly soiled, which allows for bacteria like C. auris to continue reproducing for long periods of time.
Soft Surfaces Include
- Waiting Room Chairs
- Privacy Curtains
- Blood Pressure Cuffs
- Upholstered Furniture
- Employee Uniforms
When and how to clean soft surfaces
For soft surfaces that can be laundered, surfaces should be washed as often as possible.
In addition soft surfaces should be washed:
- After each patient
- Prior to a new patient entering a room
- When soft surface items may have come into contact with an infected person
For soft surfaces that can not be laundered, such as chairs or couches, or for cleaning between washes use an Environmental Protection Agency (EPA)-registered cleaner/disinfectant, such as Clorox hydrogen Peroxide spray designed for soft surfaces to kill bacteria.
Soft surfaces which are not being washed should be wiped down daily. Some surfaces such as blood pressure cuffs will need to be wiped down multiple times a day (after every use).
Always check to make sure the product will not damage the soft surface and follow the manufacturer instructions for product use.
What Else Can I Do to Protect my Patients and Staff From Candida auris?
The CDC recommends hand hygiene procedures, such as hand washing and applying hand sanitizer, to help reduce the spread of Candida auris spores around your facility.
Encourage Frequent Handwashing
Hand hygiene is one of the most important ways to prevent the spread of illness and to avoid getting sick.
Wash your hands carefully and frequently. Scrub your hands with soap for at least 20 seconds before rinsing with running water.
Post handwashing signs around your facility to remind guests and patients of the proper procedure and importance of hand hygiene in fighting off germs.
Provide Hand Sanitizer
Hand sanitizer plays an integral role in hand hygiene and will help kill and prevent the spread of germs.
Put hand sanitizer in hallways, patient rooms, cafeterias, nurse’s stations, bathrooms, waiting rooms, and other common and high traffic areas to encourage employees, patients and guests to use it.
For the latest information and updates on the Candida auris infection, visit the CDC.
While Candida auris is still a new infection, it is important to identify patients and areas that may have come into contact with C. auris and use best practices and procedures for infection prevention.
Make it a priority to protect your facility from Candida auris. Let an EBP Specialist review your current cleaning protocols and recommend the right combination of products and processes to limit the spread of illness and keep your patients safe.
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