Relative Resistance of the Emerging Fungal Pathogen Candida auris and Other Candida Species to Killing by Ultraviolet Light

2017 ◽  
Vol 39 (1) ◽  
pp. 94-96 ◽  
Author(s):  
Jennifer L. Cadnum ◽  
Aaron A. Shaikh ◽  
Christina T. Piedrahita ◽  
Annette L. Jencson ◽  
Emily L. Larkin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Candida Species ◽  
Fungal Pathogen ◽  
Laboratory Testing ◽  
Multidrug Resistant ◽  
Relative Resistance ◽  
Candida Auris ◽  
Healthcare Facilities ◽  
Ultraviolet C ◽  
Uv C

Mobile ultraviolet-C (UV-C) light room decontamination devices are frequently used as an adjunct to standard cleaning in healthcare facilities, but their efficacy in killing Candida species is not clear. In laboratory testing, the emerging multidrug-resistant Candida auris and 2 other Candida species were significantly less susceptible to killing by UV-C than methicillin-resistant Staphylococcus aureus.Infect Control Hosp Epidemiol 2018;39:94–96

scholarly journals Environmental Surfaces in Healthcare Facilities are a Potential Source for Transmission ofCandida aurisand OtherCandidaSpecies

2017 ◽  
Vol 38 (9) ◽  
pp. 1107-1109 ◽  
Author(s):  
Christina T. Piedrahita ◽  
Jennifer L. Cadnum ◽  
Annette L. Jencson ◽  
Aaron A. Shaikh ◽  
Mahmoud A. Ghannoum ◽  
...  
Keyword(s):  
Fungal Pathogen ◽  
Laboratory Testing ◽  
Multidrug Resistant ◽  
Infect Control Hosp ◽  
Hospital Environment ◽  
Candida Auris ◽  
Healthcare Facilities ◽  
Potential Source ◽  
Environmental Surfaces

Contaminated surfaces have been implicated as a potential route for dissemination of the emerging multidrug-resistant fungal pathogenCandida auris. In laboratory testing,C. aurisand otherCandidaspecies persisted for 7 days on moist or dry surfaces.Candidaspecies were recovered frequently from the hospital environment, particularly from moist surfaces.Infect Control Hosp Epidemiol2017;38:1107–1109

scholarly journals Inactivation of Candida auris and Candida albicans by Ultraviolet-C

2020 ◽  
Vol 41 (S1) ◽  
pp. s292-s292
Author(s):  
William Rutala ◽  
Hajime Kanamori ◽  
Maria Gergen ◽  
Emily Sickbert-Bennett ◽  
David Jay Weber
Keyword(s):  
Infection Prevention ◽  
Antifungal Drugs ◽  
Candida Auris ◽  
Healthcare Facilities ◽  
Environmental Surfaces ◽  
Route Of Transmission ◽  
Indirect Exposure ◽  
Ultraviolet C ◽  
Severe Infections ◽  
Uv C

Background:Candida auris is an emerging fungal pathogen that is often resistant to major classes of antifungal drugs. It is considered a serious global health threat because it has caused severe infections with frequent mortality in over a dozen countries. C. auris can survive on healthcare environmental surfaces for at least 7 days, and it causes outbreaks in healthcare facilities. C. auris has an environmental route of transmission. Thus, infection prevention strategies, such as surface disinfection and room decontamination technologies (eg, ultraviolet [UV-C] light), will be essential to controlling transmission. Unfortunately, data are limited regarding the activity of UV-C to inactivate this pathogen. In this study, a UV-C device was evaluated for its antimicrobial activity against C. auris and C. albicans. Methods: We tested the antifungal activity of a single UV-C device using the vegetative bacteria cycle, which delivers a reflected dose of 12,000 µW/cm2. This testing was performed using Formica sheets (7.6 × 7.6 cm; 3 × 3 inches). The carriers were inoculated with C. auris or C. albicans and placed horizontal on the surface or vertical (ie, perpendicular) to the vertical UV-C lamp and at a distance from 1. 2 m (~4 ft) to 2.4 m (~8 ft). Results: Direct UV-C, with or without FCS (log10 reduction 4.57 and 4.45, respectively), exhibited a higher log10 reduction than indirect UV-C for C. auris (log10 reduction 2.41 and 1.96, respectively), which was statistically significant (Fig. 1 and Table 1). For C. albicans, although direct UV-C had a higher log10 reduction (log10 reduction with and without FCS, 5.26 and 5.07, respectively) compared to indirect exposure (log10 reduction with and without FCS, 3.96 and 3.56, respectively), this difference was not statistically significant. The vertical UV had statistically higher log10 reductions than horizontal UV against C. auris and C. albicans with FCS and without FCS. For example, for C. auris with FCS the log10 reduction for vertical surfaces was 4.92 (95% CI 3.79, 6.04) and for horizontal surfaces the log10 reduction was 2.87 (95% CI, 2.36–3.38). Conclusions:C. auris can be inactivated on environmental surfaces by UV-C as long as factors that affect inactivation are optimized (eg, exposure time). These data and other published UV-C data should be used in developing cycle parameters that prevent contaminated surfaces from being a source of acquisition by staff or patients of this globally emerging pathogen.Funding: NoneDisclosures: None

Ultraviolet-C (UV-C) monitoring made simple: Colorimetric indicators to assess delivery of UV-C light by room decontamination devices

2021 ◽  
pp. 1-6
Author(s):  
Jennifer L. Cadnum ◽  
Basya S. Pearlmutter ◽  
Sarah N. Redmond ◽  
Annette L. Jencson ◽  
Kevin J. Benner ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Laboratory Testing ◽  
Environmental Services ◽  
Dose Delivery ◽  
Methicillin Resistant ◽  
Light Delivery ◽  
Clostridioides Difficile ◽  
Device Placement ◽  
Ultraviolet C ◽  
Uv C

Abstract Objective: To evaluate the use of colorimetric indicators for monitoring ultraviolet-C (UV-C) light delivery to sites in patient rooms. Methods: In laboratory testing, we examined the correlation between changes in color of 2 commercial colorimetric indicators and log10 reductions in methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile spores with exposure to increasing doses of UV-C from a low-pressure mercury room decontamination device. In patient rooms, 1 of the colorimetric indicators was used to assess UV-C dose delivery to 27 sites in the room. Results: In laboratory testing, the manufacturer’s reference colors for MRSA and C. difficile reduction corresponded with doses of ∼10,000 and 46,000 µJ/cm2; these doses resulted in >3 log10 reductions in MRSA and C. difficile spores, respectively. In patient rooms, the colorimetric indicators demonstrated suboptimal delivery of UV-C dosing to shadowed areas, which was improved by providing cycles on each side of the patient bed rather than in a single position and altering device placement. Increasing duration of exposure increased the number of sites achieving adequate dosing to kill C. difficile spores. Conclusions: Commercial colorimetric indicators provide rapid and easy-to-interpret information on the UV-C dose delivered to sites in patient rooms. The indicators may be useful for training environmental services personnel and optimizing the effectiveness of UV-C room decontamination devices.

scholarly journals Tuning a UV-C device to challenge new threats in the sanitization setting of healthcare facilities

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Amodeo ◽  
L Pallecchi ◽  
C Nagaia ◽  
G Spataro ◽  
R Cardaci ◽  
...  
Keyword(s):  
Light Exposure ◽  
Multidrug Resistant ◽  
Candida Auris ◽  
Healthcare Facilities ◽  
Hospital Environments ◽  
Cross Transmission ◽  
Different Strains ◽  
Healthcare Associated ◽  
Uv Technology ◽  
Uv C

Abstract Background Environmental hospital hygiene plays a role in healthcare-associated infections emergency caused by resistant multi-drug organisms. The implementation of new and effective disinfection procedures is now more than ever important to prevent the cross-transmission of pathogens in the hospital facilities. In combination with common chemicals biocides, UV technology is a realistic option for environmental disinfection. In this study, we evaluate a UV device for its effectiveness on an emerging pathogen. Methods A laboratory cross section experiment was performed between August and October 2019. Two different strains of Candida auris (CBS 10913 and CBS 12372) were tested on 20 cm2 stainless steel carriers inoculated with 10 µl of bacterial culture at a concentration of 1x105 CFU/mL. The inoculum was spread until dry in aseptic condition. Carriers were placed parallel to the UV device, having 4 UV-C lamps that emit 325 W, at a fixed distance of 2.44 m. Biocidal tests were carried out in triple at three different light exposure times (5, 10 and 20 minutes). After treatment, laboratories procedures were used to detach and transfer the remaining microorganisms from the carriers to plates and compared them to controls after incubation at 37 °C for 48 h. Results A significant inactivation of C. auris already occurred at 5 minutes, reaching 3-4 log10 reduction at 20 minutes of UV-C exposure. No substantial differences were identified by analyzing the results between the two strains. Conclusions The chosen distance of 2.44 m from the target allows to ideally sanitize an entire hospital room. However, to avoid the limit of shaded areas due to the presence of non-movable objects, a couple of positions are recommended, so that shorter distances can reduce the exposure time or increase the average irradiance level of exposed surfaces. Key messages In sanitation of hospital environments, the use of viable alternatives as UV-C can contribute to the reduction of infections caused by multidrug-resistant microorganisms. Accurate testing of different space-time irradiation configurations allows to achieve important results related to the biocidal effects of UV devices.

scholarly journals Clade-specific variation in susceptibility of Candida auris to broad-spectrum ultraviolet C light (UV-C)

2020 ◽  
Vol 41 (12) ◽  
pp. 1384-1387
Author(s):  
Piyali Chatterjee ◽  
Hosoon Choi ◽  
Brennan Ochoa ◽  
Gennifer Garmon ◽  
John D. Coppin ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Multidrug Resistant ◽  
Uv Exposure ◽  
Candida Auris ◽  
Cumulative Impact ◽  
Colony Forming Units ◽  
Ultraviolet C ◽  
Specific Variation ◽  
Uv C

AbstractBackground:Candida auris is an emerging and often multidrug-resistant fungal pathogen with an exceptional ability to persist on hospital surfaces. These surfaces can act as a potential source of transmission. Therefore, effective disinfection strategies are urgently needed. We investigated the efficacy of ultraviolet C light (UV-C) disinfection for C. auris isolates belonging to 4 different clades.Methods:In vitro testing of C. auris isolates was conducted using 106 colony-forming units (CFU) spread on 20-mm diameter steel carriers and exposed to a broad-spectrum UV-C light source for 10, 20, and 30 minutes at a 1.5 m (5 feet) distance. Post-UV survivors on the coupons were subsequently plated. Colony counts and log reductions were recorded, calculated, and compared to untreated control carriers. Identification of all isolates were confirmed by MALDI-TOF and morphology was visualized by microscopy.Results:We observed an increased susceptibility of C. auris to UV-C in 8 isolates belonging to clades I, II and IV with increasing UV exposure time. The range of log kill (0.8–1.19) was highest for these isolates at 30 minutes. But relatively no change in log kill (0.04–0.35) with increasing time in isolates belonging to clade III were noted. Interestingly, C. auris isolates susceptible to UV-C were mostly nonaggregating, but the isolates that were more resistant to UV exposure formed aggregates.Conclusions:Our study suggests variability in susceptibility to UV-C of C. auris isolates belonging to different clades. More studies are needed to assess whether a cumulative impact of prolonged UV-C exposure provides additional benefit.

scholarly journals 1579. Multidrug-Resistant Candida auris Isolates From New York Hospitals and Healthcare Facilities Are Susceptible to Antifungal Combinations

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S576-S577
Author(s):  
Brittany O’Brien ◽  
Sudha Chaturvedi ◽  
Vishnu Chaturvedi
Keyword(s):  
New York ◽  
Diagnostic System ◽  
Multidrug Resistant ◽  
Drug Combinations ◽  
Antifungal Drugs ◽  
Drug Resistant ◽  
Candida Auris ◽  
Current Case ◽  
Healthcare Facilities ◽  
Broth Microdilution Method

Abstract Background Candida auris outbreak continues unabated in New York with the current case counts exceeding 300 patients. We used a modification of standard CLSI broth microdilution method (BMD) if two-drug combinations are efficacious against C. auris isolates with high-resistance to fluconazole (FZ, MIC50 >256 mg/L), and variable resistance to other broad-spectrum antifungal drugs. Methods BMD plates were custom-designed and quality controlled by TREK Diagnostic System. The combination tests of 15 drug-resistant C. auris involved microtiter wells with the initial 144 two-drug combinations and their two-fold dilutions (1/2–1/32) to get 864 two-drug combinations finally. We utilized MIC100 endpoints for the drug combination readings as reported earlier for the intra- and inter-laboratory agreements obtained against Candida species and Aspergillus fumigatus (Antimicrob Agents Chemother. 2015. 59:1759–1766). We also tested minimum fungicidal concentrations (MFC). Results We tested all possible 864 two-drug antifungal combinations for nine antifungal drugs in use to yield 12,960 MIC100 readings, and MFC readings for 15 C. auris isolates. Flucytosine (FLC) at 2.0 mg/L potentiated most successful combinations with other drugs. Micafungin (MFG), Anidulafungin (AFG), Caspofungin (CAS) at individual concentrations of 0.25 mg/L combined well with FLC (2.0 mg/L) to yield MIC100 for 14, 13, and 12 of 15 C. auris isolates tested, respectively. MFG/FLC combination was also fungicidal for 4 of 15 isolates. AMB / FLC (0.25/1.0 mg/L) yielded MIC100 for 13 isolates and MFC for three test isolates. Posaconazole (POS), and Isavuconazole (ISA) and Voriconazole (VRC) also combined well with FLC (0.25/2.0 mg/L) to yield MIC100 for 12, 13, and 13 isolates, respectively. POS/FLC combination was fungicidal for three isolates. Conclusion We identified seven two drug-combinations of antifungals efficacious against drug-resistant C. auris strains. The modified BMD combination susceptibility testing could be used by the clinical laboratories to assist providers with the selection of optimal treatment for C. auris candidemia. Disclosures All authors: No reported disclosures.

scholarly journals 1215. Ultraviolet-C (UV-C) Monitoring Made Ridiculously Simple: UV-C Dose Indicators for Convenient Measurement of UV-C Dosing

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S437-S437
Author(s):  
Jennifer Cadnum ◽  
Annette Jencson ◽  
Sarah Redmond ◽  
Thriveen Sankar Chittoor Mana ◽  
Curtis Donskey
Keyword(s):  
Methicillin Resistant Staphylococcus Aureus ◽  
Fetal Calf Serum ◽  
Color Change ◽  
Calf Serum ◽  
Organic Load ◽  
Healthcare Facilities ◽  
Log Reduction ◽  
Ultraviolet C ◽  
Effective Doses ◽  
Uv C

Abstract Background Ultraviolet-C (UV-C) light is increasingly used as an adjunct to standard cleaning in healthcare facilities. However, most facilities do not have a means to measure UV-C to determine whether effective doses are being delivered. We tested the efficacy of 2 easy-to-use colorimetric indicators for monitoring UV-C dosing in comparison to log reductions in pathogens. Methods In a laboratory setting, we exposed methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile spores on steel disk carriers with or without an organic load (5% fetal calf serum) to UV-C for varying times resulting in fluence exposures ranging from 10,000 to 100,000 µJ/cm2. The UV-C indicators were placed adjacent to the carriers. Log reductions were calculated in comparison to untreated controls and the change in color of the indicators was correlated with dose and log reductions. Results The UV-C doses required to achieve a 3-log reduction in MRSA and C. difficile were 10,000 and 46,000 µJ/cm2, respectively. For both indicators, there was a visible color change from baseline at 10,000 µJ/cm2 and a definite final color change by 46,000 µJ/cm2 (Figure 1). Organic load had only a modest impact on UV-C efficacy. The indicators required only a few seconds to place and were easy to read (Figure 2). Conclusion UV-C doses of 10,000 and 46,000 µJ/cm2 were required to achieve 3 log reductions of MRSA and C. difficile spores, respectively. The colorimetric indicators provide an easy means to monitor UV-C dosing. Disclosures All authors: No reported disclosures.

scholarly journals Bismuth Nanoantibiotics Display Anticandidal Activity and Disrupt the Biofilm and Cell Morphology of the Emergent Pathogenic Yeast Candida auris

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 461
Author(s):  
Roberto Vazquez-Munoz ◽  
Fernando D. Lopez ◽  
Jose L. Lopez-Ribot
Keyword(s):  
Antimicrobial Activity ◽  
Cell Morphology ◽  
Multidrug Resistant ◽  
Moderate Activity ◽  
Candida Auris ◽  
Pathogenic Yeast ◽  
Biofilm Growth ◽  
Healthcare Facilities ◽  
Bismuth Nanoparticles ◽  
Ic50 Values

Candida auris is an emergent multidrug-resistant pathogenic yeast, which forms biofilms resistant to antifungals, sanitizing procedures, and harsh environmental conditions. Antimicrobial nanomaterials represent an alternative to reduce the spread of pathogens—including yeasts—regardless of their drug-resistant profile. Here we have assessed the antimicrobial activity of easy-to-synthesize bismuth nanoparticles (BiNPs) against the emergent multidrug-resistant yeast Candida auris, under both planktonic and biofilm growing conditions. Additionally, we have examined the effect of these BiNPs on cell morphology and biofilm structure. Under planktonic conditions, BiNPs MIC values ranged from 1 to 4 µg mL−1 against multiple C. auris strains tested, including representatives of all different clades. Regarding the inhibition of biofilm formation, the calculated BiNPs IC50 values ranged from 5.1 to 113.1 µg mL−1. Scanning electron microscopy (SEM) observations indicated that BiNPs disrupted the C. auris cell morphology and the structure of the biofilms. In conclusion, BiNPs displayed strong antifungal activity against all strains of C. auris under planktonic conditions, but moderate activity against biofilm growth. BiNPs may potentially contribute to reducing the spread of C. auris strains at healthcare facilities, as sanitizers and future potential treatments. More research on the antimicrobial activity of BiNPs is warranted.

scholarly journals Impact of Room Location on UV-C Irradiance and UV-C Dosage and Antimicrobial Effect Delivered by a Mobile UV-C Light Device

2016 ◽  
Vol 37 (6) ◽  
pp. 667-672 ◽  
Author(s):  
John M. Boyce ◽  
Patricia A. Farrel ◽  
Dana Towle ◽  
Renee Fekieta ◽  
Michael Aniskiewicz
Keyword(s):  
Staphylococcus Aureus ◽  
Stainless Steel ◽  
Prospective Observational Study ◽  
Uv Light ◽  
Antimicrobial Effect ◽  
M 10 ◽  
Surgical Ward ◽  
Ultraviolet C ◽  
Vancomycin Resistant ◽  
Uv C

OBJECTIVETo evaluate ultraviolet C (UV-C) irradiance, UV-C dosage, and antimicrobial effect achieved by a mobile continuous UV-C device.DESIGNProspective observational study.METHODSWe used 6 UV light sensors to determine UV-C irradiance (W/cm2) and UV-C dosage (µWsec/cm2) at various distances from and orientations relative to the UV-C device during 5-minute and 15-minute cycles in an ICU room and a surgical ward room. In both rooms, stainless-steel disks inoculated with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile spores were placed next to sensors, and UV-C dosages and log10 reductions of target organisms achieved during 5-minute and 15-minute cycles were determined. Mean irradiance and dosage readings were compared using ANOVA.RESULTSMean UV-C irradiance was nearly 1.0E-03 W/cm2 in direct sight at a distance of 1.3 m (4 ft) from the device but was 1.12E-05 W/cm2 on a horizontal surface in a shaded area 3.3 m (10 ft) from the device (P<.001). Mean UV-C dosages received by UV-C sensors located at different distances and orientation relative to the device varied significantly during 5-minute cycles and during 15-minute cycles (P<.001). Log10 reductions ranged from >4 to 1–3 for MRSA, >4 to 1–2 for VRE and >4 to 0 log10 for C. difficile spores, depending on the distance from, and orientation relative to, the device with 5-minute and 15-minute cycles.CONCLUSIONUV-C irradiance, dosage, and antimicrobial effect received from a mobile UV-C device varied substantially based on location in a room relative to the UV-C device.Infect Control Hosp Epidemiol 2016;37:667–672

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