Non-sporicidal cleansers are commonly used to disinfect surfaces in the hospital rooms of patients with C auris colonization or infection, but are they efficacious?
Candida auris is an emerging public health threat that can be transmitted through contact with contaminated surfaces and equipment. Therefore, the US Centers for Disease Control and Prevention recommends the use of sporicidal disinfectants in the hospital rooms of patients with C auris colonization or infection.
The agency advises daily and post-discharge cleaning of surfaces in the patient’s respective rooms with the sporicidal disinfectant. However, non-sporicidal disinfectants that may have a US Environmental Protection Agency-registered fungal claim are widely used.
In a poster session at the Society for Healthcare Epidemiology of America Spring Conference (SHEA 2019), a team of investigators from Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University, University Hospital Cleveland Medical Center, and Louis Stokes Veterans Affairs Medical Center presented their research on the effectiveness of disinfectant wipes in reducing C auris on surfaces.
The study consisted of 2 distinct methods—the first of which involved standard testing to evaluate the efficacy of different disinfectant wipes that were made up of various active ingredients. For this method, the investigators focused on the reduction of C auris on steel, glass, and health care equipment through a modification of the ASTM standard practice E2362.
The second method involved testing in a simulated patient room. For this approach, the investigators examined the efficacy of the wipes and their potential for transferring C auris from surface-to-surface. The investigators also evaluated the benefits of UV-C, in addition to cleaning with quaternary ammonium and quaternary ammonium-alcohol wipes in a “real world” setting.
The study found that the use of all disinfectant wipes led to a >5 log10 colony forming units (CFU) reduction of C auris on steel and glass carriers, while non-disinfectant wipes led to a reduction of ~2 log.
The investigators note that in the simulation, the variable reductions were met for the health care equipment such as the call button, blood pressure cuff, and bed rail. Additionally, in the simulated room, the investigators observed that the quaternary ammonium alcohol wipe was more effective than the quaternary ammonium wipe in the overall reduction of C auris.
For the real-world simulation, the poster notes that all disinfectant methods reduced C auris by > 2 log10 CFU, which was improved through the adjunct use of UV-C.
Finally, the poster notes that quaternary ammonium disinfectant wipes transferred C auris from surface-to-surface and transfer was “lessened” by UV-C.
“Our results suggest that several non-sporicidal wipes that are commonly used in health care facilities may be effective in reducing C auris on various surfaces,” the investigators write, noting that mechanical action and antimicrobial activity both contribute to the decontamination of surfaces.
The investigators also indicate that UV technology may be a useful adjunct to disinfectant wipes and that efficacy may be lower on real-world surfaces in comparison with standardized test surfaces.
The poster, “Effectiveness of Disinfectant Wipes in Reducing Candida auris on Surfaces,” was presented on April 24, 2019, at SHEA 2019 in Boston, Massachusetts.