Biocidal Surfaces and the Fight Against Multi-Drug Resistant C. auris

by Erica Mitchell | January 21 2022 | 1 Comment

c auris 2022-01When a pathogen develops resistance to all drugs used against it, even a weak strain of it can cause dangerous outcomes in patients. When that same pathogen is also resistant to common cleaners and disinfectants, you are facing a foe that persists on surfaces, ready to attack the next vulnerable host. This is the scenario hospitals are facing with Candida auris, a fungus that has recently be identified in a Louisiana hospital, the first that state has seen. In today's post, we'll examine the role that biocidal surfaces can play in the control and eradication of a pathogen that can escape almost everything else.

Candida auris was first identified in 2009, and has since circled the world many times over, leading to at least 5 distinct clades. A species in one of the more common fungal genera, Candida, the C. auris strain is found exclusively in healthcare environments, where it has developed resistance to many antifungal treatments. Over 90% of the isolates tested are resistant to at least one of the 5 classes of antifungals, with more than 30% being resistant to three or more. This resistance, not the virulence, accounts for the shocking 30-60% mortality rate associated with these infections.

Not only has the fungal strain developed resistance to medical treatments, it has also developed resistance to common cleaners and disinfectants. Quaternary ammonium compounds, called Quats, along with acetic acid cleaners, are not effective against C. auris, which requires enhanced terminal cleaning with bleach or chlorine and additional cycle times for ultraviolet radiation (UV) disinfection. With the minimum contact time required for transmission estimated at around 4 hours, C. auris has more than enough time to shed and spread between routine cleanings.

A solution to the resistance and persistence of this pathogen that can be implemented today is the use of copper-infused biocidal surfaces. Recent testing indicates that copper-infused solid surface, EOSCU, can kill greater than 99.99% of C. auris in just 2 hours, well below the minimum contact time. Patient rooms equipped with biocidal bed rails, overbed tables, and horizontal surfaces could eliminate C. auris cells in under 2 hours, significantly lowering the risk of transmission while the patient is still present, and in turn reducing the risk that future residents of the room would be exposed.

How can surfaces play a role in helping control outbreaks of C. auris? To answer that question, we have to look at the role surfaces play in transmission. C. auris can be present on a person's body without the presence of infection (colonization), shedding onto surfaces touched by that patient. Healthcare worker hands - or clothes, or equipment - touching that surface can then carry the fungus to a patient with an open wound or an indwelling device, such as a catheter or ventilator, and transfer the fungus to that vulnerable person.

Take the situation in Louisiana right now: One patient came into the hospital with C. auris, and two more (so far) have acquired it just by being in the same hospital. While we cannot specifically point to the exact route of transmission, we know from previous research that regular surfaces play a significant role in the transmission of hospital-associated infections. We also have statistically significant scientific evidence that biocidal surfaces have the innate ability to break this chain of transmission, lowering the risk of outbreak and preventing this dangerous fungus from persisting and continuing to spread.

For additional information about the EOSCU testing results for C. auris, please contact our office.