Successful Environmental Disinfection to Prevention Transmission of Candida Auris

BACKGROUND: Candida auris is a globally-emerging, multidrug-resistant yeast causing invasive infections and can persist on environmental surfaces if not adequately disinfected. Last summer, two patients with C. Auris infections were admitted at University of Chicago Medicine (UCM). Environmental samples were collected to assess environmental contamination before and after cleaning. METHODS: Environmental samples were collected using 3M Sponge Sticks with neutralizing Buffer during one patientÕs stay, weeks after another patientÕs stay, and after enhanced terminal cleaning. Samples were cultured directly and yeast was identified using MALDI. The following surfaces were sampled: Bathroom sink drain, bedside table, bedrail, mattress, chair and window ledge. Routine terminal cleaning includes 10% sodium hypochlorite solution applied high touch surfaces of both room and bathroom. The enhanced terminal cleaning process used for these rooms included: (1) 10% sodium hypochlorite solution applied to all high touch surfaces and walls; (2) privacy curtains removed and replaced; (3) supervision by environmental services manager; and (4) single UV disinfection cycle in room and bathroom. RESULTS: Because of delay in identification of C auris for the first patient, pre-clean samples were taken >2 weeks after the patient had been discharged. During the intervening weeks, multiple patients had occupied the room and there had been >3 routine terminal cleanings. None of these samples were positive for C auris. Pre-clean, in-residence samples indicated C auris contamination of multiple surfaces for the second patient. Because of transfers within the institution, there are three sets of post-cleaning cultures for the second patient. All post-clean environmental cultures were negative for both patients. Results are shown in Figure 1. CONCLUSION: Candida auris can contaminate environmental surfaces. While routine terminal cleaning may have been effective in removing C auris from surfaces in one patientÕs room, the enhanced terminal cleaning strategy used here was effective in our facility. DISCLOSURES: J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient