Effectiveness of a sodium hypochlorite isotonic solution in decolonization of patients with Candida auris: Learnings from a county health care system.
Bathing protocols
Invasive infection
Isotonic hypochlorite solution
Multidrug-resistant fungus
Skin decolonization
Journal
American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854
Informations de publication
Date de publication:
23 Nov 2023
23 Nov 2023
Historique:
received:
31
05
2023
revised:
10
11
2023
accepted:
11
11
2023
pubmed:
26
11
2023
medline:
26
11
2023
entrez:
25
11
2023
Statut:
aheadofprint
Résumé
Candida auris (CA) is an organism that has spread globally over the last decade. We conducted a quality improvement project with the aim of decreasing or eliminating skin colonization of patients with CA through a modified bathing protocol. An isotonic hypochlorite solution was added to routine bathing protocols for hospitalized patients colonized with CA. Weekly skin swabs from axillary and inguinal areas were tested for the presence of CA using polymerase chain reaction and culture. Multidisciplinary efforts, such as environmental terminal cleaning, dedicated equipment, education, and signage were reinforced among staff to improve patient outcomes. A total of 24 patients were included. After 4 weeks of a modified bathing protocol, 81.2% of the patients remained colonized with CA. Three patients were discharged safely to their homes and 3 were transferred to long-term care acute hospitals. Nine patients remained hospitalized after 60 days. Localized rash was reported in 3 patients, which resolved after discontinuation of the product. Modification of our bathing protocols by including an isotonic hypochlorite solution did not lead to skin decolonization of CA. Further studies are needed to identify effective measures to eradicate, eliminate or reduce colonization.
Sections du résumé
BACKGROUND
BACKGROUND
Candida auris (CA) is an organism that has spread globally over the last decade. We conducted a quality improvement project with the aim of decreasing or eliminating skin colonization of patients with CA through a modified bathing protocol.
METHODS
METHODS
An isotonic hypochlorite solution was added to routine bathing protocols for hospitalized patients colonized with CA. Weekly skin swabs from axillary and inguinal areas were tested for the presence of CA using polymerase chain reaction and culture. Multidisciplinary efforts, such as environmental terminal cleaning, dedicated equipment, education, and signage were reinforced among staff to improve patient outcomes.
RESULTS
RESULTS
A total of 24 patients were included. After 4 weeks of a modified bathing protocol, 81.2% of the patients remained colonized with CA. Three patients were discharged safely to their homes and 3 were transferred to long-term care acute hospitals. Nine patients remained hospitalized after 60 days. Localized rash was reported in 3 patients, which resolved after discontinuation of the product.
CONCLUSIONS
CONCLUSIONS
Modification of our bathing protocols by including an isotonic hypochlorite solution did not lead to skin decolonization of CA. Further studies are needed to identify effective measures to eradicate, eliminate or reduce colonization.
Identifiants
pubmed: 38007101
pii: S0196-6553(23)00786-1
doi: 10.1016/j.ajic.2023.11.008
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.