Candida auris & ESKAPE Bacteria Pathogen Testing

Environmental Surfaces in Disease Transmission

It has been well-established that environmental surfaces play an important role in the endemic and epidemic transmission of certain pathogens that cause healthcare-associated infections¹.  These bacteria (especially the so-called ESKAPE bacteria; see below) and certain fungal/yeast pathogens (especially Candida auris²) share the ability to be shed from infected or colonized patients, survive as infectious agents on dry surfaces for extended periods, are difficult to treat because of multiple drug-resistances (MDRs), and are difficult to eradicate from their environmental locations, even with the recommended cleaning and disinfection agents and practices.

Microbial Surveillance of Touch Surfaces

Because of the complexity in the different types of touch surfaces in healthcare institutions, it is difficult to confirm the complete absence of any one pathogen on those surfaces, despite the rigor of the cleaning and disinfection program in place.  As a result, the requirements for surface hygiene in clinical spaces are not as well characterized as are the microbial safety requirements and standards for hospital water or air.

Nevertheless, as shown in a recent study by Watkin and colleagues from the University College London³, a routine surface hygiene microbial surveillance program of touch surfaces in a hospital can not only help to identify the source of infectious diseases outbreaks when they occur (Rapid Response), but may also help to prevent outbreaks of these infectious diseases in the first place (Disease Prevention)

¹Otter, J.A. et. al.  (2013). Evidence that contaminated surfaces contribute to the transmission of hospital pathogens and an overview of strategies to address contaminated surfaces.  Am. J. Infect. Control. 41: S6-S11.

²Du, H., et al.  (2020). Candida auris: Epidemiology, biology, antifungal resistance, and virulence. PLoS Pathog. 16 (10): e1008921.

https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1008921

³Watkin et al., How can monitoring touch surfaces for microbial contaminants support infection control practice?; Presented at: ASM Microbe; June 15-19, 2023, Houston, TX.

Candida auris

A drug-resistant pathogen that spreads in healthcare facilities.

Candia auris (C. auris) is a yeast that demonstrates an ability to evade host innate immunity⁴ as well as to express multi-drug resistance. C. auris was first identified in 2009 in Japan (CDC.gov, n.d.; Weerasinghe et al., 2023) and has been present in the United States since 2013. C. auris is one of the leading causes of invasive candidiasis, a healthcare acquired infection (HAI) that often presents in immunocompromised individuals. Treatment of invasive candidiasis caused by C. auris is profoundly difficult. C. auris can easily be misidentified as other Candida species, and due to its multi-drug resistance, the effectiveness of most antifungals is limited. This presents a difficult scenario, where a patient infected with C. auris could be subject to delayed and ineffective treatment. All these factors may contribute to the high mortality rate of 30-60% that has been observed so far.