Candida auris: a serious challenge for the medical and health sciences

​A recent study found that Candida auris can tolerate disinfectants in surfaces, which can be related to its ability to persist in the hospital environment

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Candidiasis is the main fungal disease that occurs in hospitalized or immunosuppressed patients. To avoid these complications, it is vital to maintain the health-care environment as much clean as possible.

In 2017, the World Health Organization has launched a campaign “Hands Clean: Saves Lives (Fight antibiotic resistance - it's in your hands)”, in order to sensitize health workers for the importance of always keeping the hands clean, before and after any medical procedure, to prevent germ spread through surfaces or equipment: http://www.who.int/gpsc/clean_hands_protection/en/ and http://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf.

The use of antiseptics and disinfectants is an essential practice in hospitals, but do they actually have any effectiveness against the most concerning microorganisms?

In a recent paper, Gordon Ramage and his team studied the capacity of several clinical isolates of Candida auris to survive on surfaces and withstand sodium hypochlorite and peracetic acid. C. auris is a multidrug-resistant yeast that has showed to survive on steel and plastic surfaces up to 4 weeks and its viability has been compared to Candida parapsilosis. The researchers found that C. auris can tolerate clinically relevant concentrations of the two disinfectants in a surface dependent manner, which could explain its high capacity to persist in the hospital environment. The results also showed comparable disinfectant sensitivity profiles for both C. auris and Candida glabrata, also related to cases of multidrug resistance.

This interesting work highlights the importance of:

  • a constant updating the guidelines to hospital disinfection procedures
  • a better understanding of the physiopathology of C. auris

Abstract

The emerging pathogenic multidrug-resistant yeast Candida auris is an important source of healthcare–associated infections and of growing global clinical concern. The ability of this organism to survive on surfaces and withstand environmental stressors creates a challenge for eradicating it from hospitals. A panel of C. auris clinical isolates was evaluated on different surface environments against the standard disinfectant sodium hypochlorite and high level disinfectant peracetic acid. C. auris was shown to selectively tolerate clinically relevant concentrations of sodium hypochlorite and peracetic acid in a surface dependent manner, which may explain its ability to successfully persist within the hospital environment.

Reference: Kean R, Sherry L, Townsend E, McKloud E, Short B, Akinbobola A, Mackay WG, Williams C, Jones BL, Ramage G, Surface disinfection challenges for Candida auris: an in vitro study, Journal of Hospital Infection (2018), doi: 10.1016/j.jhin.2017.11.015.

http://www.journalofhospitalinfection.com/article/S0195-6701(17)30642-4/pdf

Go to the profile of Celia Fortuna Rodrigues

Celia Fortuna Rodrigues

PharmD, PhD , University of Minho

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