Becker's Clinical Quality & Infection Control

28 INFECTION CONTROL & PATIENT SAFETY CDC Warns US Hospitals of Emerging, Deadly Yeast Infection: 7 Things to Know By Heather Punke T he CDC has issued a clinical alert to healthcare facili- ties in the U.S. about an emerging, multidrug-resistant yeast called Candida auris that is causing invasive, highly deadly infections across the world. e following are seven things to know about C. auris and the CDC's response. 1. e multidrug-resistant yeast causes bloodstream infections, wound infections and middle ear infections. Most of the doc- umented C. auris yeast infections have been hospital-acquired, with patients contracting the fungus weeks into their hospital stay. 2. Diabetes, recent surgery, recent antibiotics and the presence of central venous catheters all are risk factors for a C. auris in- fection. 3. Most C. auris isolates have shown resistance to common anti- fungal drugs, which means treatment options would be limited. 4. Only one isolate of C. auris was located in the U.S. in 2013, but has been found in nine countries on four continents since 2009. e earliest known infection caused by the fungus happened in South Korea in 1996. "CDC is concerned that C. auris will emerge in new locations, including the United States," the health alert reads. 5. At least two countries have described healthcare outbreaks of C. auris infections involving more than 30 patients each. While the yeast's mode of transmission is not yet known, evidence suggests C. auris could contaminate the rooms where infected patients stayed. "Good infection control practices and environmental cleaning may help prevent transmission," accord- ing to the CDC health alert. 6. e CDC issued the following interim recommendations for hospitals to prevent C. auris transmission: • If a healthcare facility suspects a patient has C. auris, it should contact state and local public health authorities as well as the CDC. • Patients colonized or infected with C. auris should be placed in a single room and healthcare personnel should use Standard and Contact Precautions, as the agency is still working to develop definitive infection control guidance for the yeast. • Healthcare facilities with colonized or infected patients should make sure to perform thorough daily and terminal cleaning and disinfection of the patients' rooms with an EPA-registered hospital-grade disinfectant with a fungal claim. 7. C. auris closely resembles other fungi, and commercially available tests used in many U.S. labs cannot differentiate this strain from other related species. "Clinical, state and public health laboratories should be aware of this organism and of the limitations in its identification," the health alert reads. n Hospital Worker Cellphones Are Hotbeds for Fungus, Study Finds By Heather Punke T he Candida fungus was found on the majority of cell- phones belonging to employees at a hospital in Poland, ac- cording to research published in BMC Infectious Diseases. Candida can live on the skin and mucous membranes without causing an infection, but, according to the CDC, "overgrowth of these organisms can cause symptoms to develop." Candida can cause thrush, yeast infections and bloodstream infections. Researchers tested 175 mobile phones and the hands of staff members at University Hospital in Bialystock, Poland. They found 131, or 74.9 percent, of the tested phones were colonized with the fungus. The dominant species identified were Candida albicans, C. glabrata and C. krusei. Further, just 19.4 percent of participants reported cleaning the surface of their phones. "These results pose the need to develop guidelines for mo- bile phone disinfection," the study authors concluded. n Central Line Infection Prevention Bundle Reduces CLABSIs Among Newborns By Shannon Barnet A ustralian researchers demonstrated a central line infection preven- tion bundle could reduce the number of central venous catheters inserted and the number of central line-associ- ated bloodstream infections in babies in a new study published in Infection Control & Hospital Epidemiology. The retrospective cohort study was conducted in a Level V neonatal intensive care unit at the Royal Prince Alfred Hos- pital in Sydney. The bundles examined in the study encom- passed the insertion of the CVC, CVC maintenance, an education program and ongo- ing surveillance and feedback protocols. The baseline and interven- tion groups were compara- ble in clinical characteristics, but highlighted below are three ways the outcomes of the groups differed. 1. The number of inserted CVCs was much lower in the intervention group than the baseline group, with central line utilization rates of 0.2 and 0.16, respectively. 2. Peripherally inserted CVC dwell time was also lower in the intervention group, at 6 days compared to 7.3 days. 3. CLABSIs were significantly reduced, "predominantly secondary to decreased pe- ripherally inserted CVC-relat- ed bloodstream infections," according to the study. The intervention group had 1.2 infections per 1,000 central line-days compared to 11.5 infections per 1,000 central line-days in the baseline group. n

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