CloroxPro Blog – Professional Cleaning and Disinfection Insights

What first comes to mind when you hear “fungi”? 

If you work in a hospital or long-term care facility, “fungi” could quickly summon thoughts of a range of pathogenic fungi and the corresponding range of diseases that can threaten vulnerable patients.    

Fungi are among the most abundant and diverse of all organisms, but human  pathogenic fungi represent just a small subset of all environmental yeasts and moulds. Pathogenic fungi can be acquired by a variety of routes, typically direct skin contact or inhalation of airborne forms. 

We’re routinely exposed to various species of yeasts and moulds, and some are even part of our microbiome – our gut, skin and mucosa. Fungal infections can occur in healthy individuals – think athlete’s foot or diaper rash – and for the most part, a good immune defense system will keep them at bay. But in patients who are immunocompromised or on immunosuppressant therapy (e.g., for organ transplant or neoplastic diseases), these opportunistic pathogens can cause serious illness or death. 

Candida auris (C. auris): yeast

• A multidrug-resistant nosocomial pathogenic yeast; first identified in 2009 in Japan
• Implicated in severe infection and outbreaks in healthcare settings worldwide
• Initially was difficult to identify in laboratory so was able to spread unrecognized
• Can colonize the skin and proceed to cause serious invasive infections; mortality rate of 40-70%

How does C. auris spread?

C. auris has caused outbreaks within healthcare facilities via person-to-person contact and through contaminated surfaces or equipment. C. auris can persist on a variety of surfaces in within healthcare units – patient rooms, ICUs, sinks, floors, tables – and can spread rapidly within healthcare units on shared mobile equipment such as blood pressure monitors, phones, thermometers and carts. 

Aspergillus fumigatus: mould

• Widespread in nature, found in soil, decaying vegetation, air-conditioning and heating systems, and household items 
• Forms hardy spores that can survive for a long time 
• An opportunistic organism affecting the elderly, individuals with weakened immune systems, chronic lung conditions or who are on immunosuppressive therapy
• “Aspergillosis” refers to a range of resulting infections that can affect areas throughout the body; infection may be resistant to commonly used antifungal medicines

How does Aspergillus fumigatus spread?

Transmission occurs through inhaling airborne spores; it is not contagious from person to person. Healthcare-associated infections may be associated with dust exposure during building renovation or construction. Occasional outbreaks of skin-based infection have been linked to contaminated medical devices.

Pneumocystis jirovecci

• An unusual fungus: found in the respiratory tracts of humans and mammals but an environmental source hasn’t been identified
• Opportunistic pathogen that can cause an asymptomatic or mild infection in individuals with healthy immune systems 
• Pneumocystis jirovecii pneumonia is a fungal infection of the lungs that most commonly affects the immunocompromised; can be life-threatening

How does Pneumocystis jirovecci spread?

Pneumocystis jirovecci is transmitted from person to person through an airborne route. Lung colonization can occur in people with normal immune systems, who do not develop symptoms but may become asymptomatic carriers to immunocompromised individuals.

Special considerations for fungal pathogen management

Managing fungal pathogens to prevent transmission and spread of hospital-acquired infections requires different approaches based on the method of transmission of the suspected infectious agent. 

Airborne pathogens

Dealing with airborne fungal pathogens like Aspergillus fumigatusand Pneumocystis jiroveccirequires specific precautions that differ from methods for dealing with surface contamination, as with C. auris.

The control and prevention of airborne transmission of infections is far from simple; methods include both physical facility-based strategies and preventive practices for staff. While a specially designed ventilator system is beyond the  responsibility of healthcare and facility staff, the practice of antiseptic techniques, wearing personalized protection equipment (PPE), and performing basic infection prevention measures like handwashing are standard best practices. 

C. auris

Because C. auris can live on surfaces for several weeks, and thus spread easily in healthcare facilities, effective cleaning and disinfection protocols are essential. 

• Enhanced cleaning and disinfection of patient care environments and reusable equipment should be done 2-3 times daily with recommended products.
• Contact time plays a critical role in the cleaning and disinfection process: the Government of Canada recommends that products intended to disinfect high-contact environmental surfaces should be effective within 5 minutes. 
• Public Health Ontario reports that sodium hypochlorite and hydrogen peroxide (0.5%, 1.4%) are effective agents against C. auris on hard non-porous surfaces.

General principles and best practices: Check the label

Although the complexity of the healthcare environment may require the use of more than one disinfectant product, every effort should be made to limit the total number of different products in use. This simplifies the cleaning process, minimizes training requirements for environmental service staff, and reduces the potential for errors.

Factors influencing the choice of disinfectant:

• The disinfectant must have a DIN from Health Canada
• Efficacy and spectrum of activity 
• Ease of use: 
  • Sufficient contact time for efficacy 
  • Simple to prepare and use at the required concentration
  • One-step cleaner and disinfectant
• Compatible with the items and surfaces requiring disinfection
• Safe for use for both staff and patients

Hydrogen peroxide is an oxidizing agent that produces hydroxyl free radicals, which destroy membrane lipids, DNA and other cell parts of bacteria, viruses, spores, yeast and fungi. Hydrogen peroxide is effective against the spread of C. aurison hard non-porous surfaces when used as directed.

Clorox Healthcare™ Hydrogen Peroxide Cleaner Disinfectant Wipes can be used to effectively manage C. auris on environmental surfaces and equipment in healthcare settings.

Is your Cleandom ready for ready-to-use wipes?

Ready-to-use wipes combine sanitizing/disinfecting agent, water, container and wipe together in a controlled environment. This greatly reduces the risks of contamination or compromise to efficacy and safety – plus they save valuable staff time, especially when dealing with enhanced cleaning requirements such as those for C. auris.

Clorox Healthcare™ Hydrogen Peroxide Cleaner Disinfectant Wipes (DIN: 2406225)

• Active ingredient: hydrogen peroxide.
• Contact time: 30 seconds to 4 minutes.
• C. auris contact time: 2 minutes.

Effective against*

• Kills TB and 15 other pathogens in 1 minute. 
• Kills 59 pathogens in 30 seconds to 4 minutes.
• 30 seconds to 1 minute contact times on most bacteria and viruses.

Use

• Ideal for daily use in high-turnover areas.
• No benzyl alcohol.
• Comes in a range of sizes and formats to meet your needs on hard surfaces, including clinical use, daily patient room cleaning, terminal cleaning and on-the-go disinfecting.

* When used as directed.

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