The world is becoming warmer and wetter, and humans are becoming vulnerable to a wide variety of fungi that are growing into a global problem. Although many fungi are extremely contagious, most are not life-threatening to humans. This includes those that cause bothersome but treatable conditions like ringworm, athlete’s foot, dandruff, and thrush.
However, many fungi types are dangerous to people, especially those who are immunocompromised, use invasive medical devices, or stay in medical care facilities for extended periods. Globally, 1.5 million people die each year from various fungal infections.
Some new types of fungi don’t respond to conventional means of eradication, which means that everyone, especially cleaning companies and medical professionals, needs to stay on top of the latest news concerning fungi. This is especially true with a fungus called Candida auris, more commonly known as C. auris.
If you need professional cleaning services for your medical office or facility, reach out to 360Clean for a free estimate.
What Is Candida Auris?
According to the CDC, Candida auris poses a serious global threat. In several countries, the fungus has been causing severe illness in people who are at risk. In some people, this fungus enters the bloodstream and is carried throughout the body, causing critical infection.
Usually, a class of medications called echinocandins is used to treat fungal infections successfully. However, for the most part, C. auris doesn’t respond to them. It’s also not easy to identify the fungus. Specialized laboratory methods are required to do so. Typical lab identification techniques simply don’t work.
Risk Factors for C. Auris Infection
Risk factors for the fungus are similar to those for other Candida infections, including diabetes, surgery, and a history of a compromised immune system. However, it’s generally non-threatening to healthy people.
Those most prone to infection are people who have a central venous catheter or any tubing or lines going into the body, people who have been hospitalized for a long time, and those who received antibiotics or antifungal medications in the past.
A retrospective review found that the earliest strain of C. auris was in South Korea in 1996. It was first positively identified in 2009 in Japan. C. auris was first reported in the U.S. in 2016, with 3,270 cases of infection from 2016 through the end of 2021. Infectious cases have risen every year since then, with the sharpest increase between 2020 and 2021.
There were 7,413 screening cases between 2016 and 2021. Screening cases are those in which the fungus is present in a person but not causing infection. From 2020 to 2021, screening cases tripled. The CDC considers the fungus an “emerging pathogen” because the number of infections continues to increase in many countries.
It’s now been reported in more than 30 countries. However, since specialized laboratory methods are needed for identification, C. auris is likely in several other countries that haven’t identified the fungus yet.
Why Candida Auris Is So Concerning
There are thousands of types of fungi throughout the world, many of which are potentially harmful to humans. So why is the CDC so concerned about this one? There are three big reasons for this concern:
- It is resistant to conventional antifungal medications, making it extremely difficult to treat
- Standard laboratory methods cannot identify C. auris, and it’s often misidentified, leading to mismanagement, misdiagnosis, and mistreatment
- It causes outbreaks in healthcare settings, where people are already susceptible to illness
The fungus can cause more than one type of infection, too. So far, it has been known to cause ear, bloodstream, and wound infections. It may also cause bladder and lung infections, although this information is still inconclusive.
The risk to people in healthcare facilities extends beyond just patients. It also poses risks to facility staff members, visitors, vendors, administration, and cleaning and janitorial crews. Infections have been found in people of all ages, from newborns to the elderly.
C. Auris Infections Can Be Fatal
One of the biggest causes for such concern over this type of fungus is the fact that invasive infections with any Candida species can be fatal, and since this one is so difficult to treat, the risk of death goes up.
Just how fatal is it? The CDC reports that based on limited information, anywhere from 30-60% of people with infections from C. auris have died. However, it’s important to understand that many of those patients had other illnesses and complications that increased their risk of death.
Keep in mind, too, that C. auris is generally not a threat to people in good health.
How Does C. Auris Spread?
The blame for much of the contamination across the globe lies with poor identification methods and a lack of awareness. However, one reason for its spread is poor infection prevention control in healthcare facilities.
That has been cited as the main reason for the increase in cases in the U.S. This was especially true during 2020 and 2021 due to the strain on healthcare systems during the height of the COVID-19 pandemic.
- auris is spread by living on the skin of infected people and traveling to surfaces. Therefore, it can spread through interpersonal contact and from contaminated surfaces.
The CDC suggests several things you can do to limit the spread and suppress fungal growth:
- Thoroughly clean and dry any and all damp areas
- Ventilate laundry rooms, cooking areas, and shower areas
- Avoid installing carpet in areas with high humidity levels
- Keep room humidity levels no higher than 50%
- Swiftly fix leaky pipes, windows, and roofs
Certain implications apply to the professional cleaning industry, especially those that clean healthcare or medical facilities.
What Do These Fungi Mean for the Cleaning Industry?
It’s no secret that the cleaning industry has endured its fair share of battles with pathogens over the past few years, from COVID-19 in 2020 to monkeypox in 2022. Many people are wondering if fungi will be the main enemy in 2023. In October 2022, the World Health Organization released a list of health-threatening fungi for the first time.
Remember that no indoor space, even a surgical operating room, is completely free from mold, a fungus normally not harmful in micro amounts. However, C. auris is highly contagious and can thrive on medical equipment and surfaces in healthcare facilities. What can make it so difficult to treat is that it behaves more like a bacteria, changing to develop resistance to medications and cleaning disinfectants.
Currently, there are three classes of antifungal medications, and C. auris has shown an ability to become resistant to all three of them. This essentially makes it an unkillable, virtually untreatable superbug. It can also survive outside the human body for up to a month or even longer.
Cleaning professionals can take appropriate action if fungi are found in the facility they take care of, whether it’s mold, C. auris, or any other type:
- Eliminate moisture from the area by removing damp objects, bringing in fans, etc.
- Disinfect or replace soft items like carpeting and upholstered items, curtains, and bedding
- Disinfect hard surfaces like molding, flooring, metal furniture, sinks, tables, and similar surfaces
HVAC systems in moist areas should be inspected and cleaned by HVAC professionals. This is especially true if in-room air conditioning systems are present, such as those in medical offices and hospital rooms.
The CDC recommends that cleaning professionals use commercial cleaning products, soap with water, or a bleach solution. If using a bleach solution, it should be no more than one cup of bleach per each gallon of water.
Bleach should never be mixed with other cleaning products, vinegar, or ammonia. Professionals must always ensure that the area where bleach is used is well-ventilated.
Disinfecting Healthcare Facilities with C. Auris Infections
Unfortunately, C. auris lingers on surfaces in healthcare facilities. It’s been cultured from both low-touch and high-touch surfaces, from window sills to call buttons. It’s also been found on reusable and mobile equipment that is shared between people, including nursing carts, blood pressure cuffs, and glucometers.
Terminal cleaning and disinfection of areas is paramount, as is disinfecting reusable equipment. Professionals must always apply cleaning products for the correct contact time for them to be as effective as possible.
This can be a challenge if staff is pressed for time. However, it’s vital that if the contact time for a product is five minutes, that product is left on the surface for the full five minutes.
Disinfecting Products to Reduce the Spread of Candida Auris
The Environmental Protection Agency (EPA) first registered products to reduce transmission of the C. auris fungus back in February 2020. There were 11 products on the original list. Now, there are dozens.
Before the first 11 products, no antimicrobial pesticides were registered specifically as a tool against C. auris. Today, the EPA and CDC both recognize disinfection’s important role in stopping the spread of C. auris infections and illnesses.
Using a hospital-grade disinfectant that is registered with the EPA is vital. There are cleaning and disinfecting products that are approved as being effective against C. auris. These products are found in the EPA’s List P.
Some of the ingredients in these approved products include:
- Hydrogen peroxide
- Peracetic acid
- Octanoic acid
- Dodecylbenzenesulfonic acid
- Sodium hypochlorite
- Isopropyl alcohol
- Quaternary ammonium
Some of the product brand names include the following:
- CaviWipes 1
- Micro-Kill Bleach Germicidal Bleach Wipes
- Cavicide 1
- Sterilex PAA 5.9
- Oxycide Daily Disinfectant Cleaner
- Disinfectant 1 Spray
- Disinfectant 1 Wipe
- Micro-Kill Bleach Solution
- CPPC Tsunami
- Sani-Cloth Germicidal Wipes
- Peridox RTU
- MBS MedTech Germicidal Disposable Wipes
- Wonder Woman Formula B Spray
These are just some of the dozens of cleaning products on the EPA’s list of antimicrobial products registered for claims against C. auris. Some are ready to use, and others must be diluted before use. All the products on the list are designed for use on hard non-porous surfaces. Furthermore, products with an EPA claim for being effective against C. difficile also seem effective against C. auris.
The Critical Role of Environmental Cleaning Professionals
Environmental service departments, janitorial crews, and cleaning companies all play a vital role in preventing the spread of this dangerous fungus and others. Infected people should be placed in a room away from other patients, and that room should be cleaned frequently with one of the aforementioned EPA-registered solutions.
The EPA also recommends that custodial departments and cleaning personnel conduct a survey to map locations of all hard and soft surfaces in patient areas. They should re-familiarize themselves with the CDC’s protocols for disinfection and sterilization and regularly check the CDC website to review the latest guidelines on managing the fungus.
Trust 360Clean for Healthcare Facility Disinfecting
Not every cleaning crew takes its job as seriously as 360Clean does, and no one is more thorough when it comes to stopping the spread of C. auris and other pathogens. Contact us today for a free quote or estimate on cleaning your facility!