According to the New York Times on April 6, Mount Sinai Hospital in New York City found an elderly man infected with a "mysterious and fatal" fungus during abdominal surgery last May. The hospital quickly isolated him in intensive care unit. At present, 18 people have been confirmed to be infected in China. So how to do a good job of prevention in daily life?
90 days later, the man died in the hospital, but the deadly fungus survived tenaciously. The hospital carried out special disinfection on the walls, beds, doors, sinks and telephones, and even removed part of the ceiling and floor.
Currently, the superfungus is endemic in 12 states, including New York, New Jersey and Illinois.
The Centers for Disease Control and Prevention (CDC) of the United States recently listed Candida auralis as an "emergency threat". According to the latest report on its official website, the number of infection cases in the United States has risen to 587, and nearly 50% of the infected people died within 90 days.
Chinese mainland has identified 18 cases of Candida infection clinically.
Many people feel a sense of panic after watching, thinking that they may also be infected.
In fact, we don't have to panic at all. Why?
Candida auralis is a kind of nosocomial infection, and the general public is not susceptible to it
In fact, as early as 2009, some researchers found this kind of Candida in the external auditory canal secretion of a Japanese patient, which is a kind of nosocomial infection.
What is nosocomial infection?
In short, the infection in the hospital generally occurs in people with underlying diseases (especially hospitalized patients). Normal people are not easy to be infected.
This kind of super fungal infection mainly occurs in patients with long-term use of venous / arterial indwelling catheter, after surgery or immune deficiency. The general population need not panic too much.
The CDC of the United States has also warned medical institutions that Candida auralis usually infects patients through wounds, ventilators and catheters, especially patients in hospitalized and long-term care institutions.
In other words, the hospitalized patients who did not use the catheter for a long time and did not have severe immunodeficiency basically had no risk of infection.
Why do American CDCs pay so much attention to Candida auralis?
Candida auralis is a new kind of fungus. There are three main reasons why American CDC pays attention to Candida auralis
Candida auratus is generally multi drug resistant, which means that it can resist a variety of antifungal drugs commonly used to treat the infection. Even fluconazole, which is commonly used in clinic, is helpless and difficult to treat, which can lead to death.
Diagnosis and identification are difficult. It is difficult to identify the strain by standard laboratory methods, and it may be mistakenly identified as other Candida without specific technology.
It has caused an outbreak of nosocomial infection in medical institutions. Therefore, the key is to quickly identify Candida auralis in hospitalized patients, so that medical institutions can take preventive measures to prevent its spread.
Wang Hui, director of the Department of laboratory medicine of Peking University Medical Department and director of the Department of laboratory medicine of Peking University People's Hospital, also said, "super fungi can survive on the skin of patients and medical staff and the surface of hospital facilities for a long time. If the infection control measures are not effective, it is easy to lead to explosive infection in the hospital. 」
How to prevent and control infection effectively?
So what should medical institutions, especially hospital staff and medical staff, do?
In August 2017, the UK Department of public health (PHE) updated the current guidelines on Candida auralis. The specific control measures are as follows:
Key sensory control measures for patients
1. Isolation of colonized or infected individuals in a single room requires independent bathroom facilities.
2. For patients transferred from infected hospitals or foreign hospitals, isolation measures were taken until the screening results were obtained.
3. Strictly abide by the standard preventive measures, wash hands with flowing water and soap, and then disinfect hands with quick drying hand disinfectant.
4. Personal protective equipment such as gloves and aprons, if there is a risk of contact with the patient's skin, blood or body fluid, should wear isolation clothing.
5. Personal protective equipment should be worn after washing hands and before entering the room or patient area, and should be taken off and discarded in the patient's room. Before leaving, hands should be washed thoroughly and wiped with quick drying hand disinfectant.
6. Patients and visitors need to master infection prevention measures (brochures can be used), including hand hygiene and how to use aprons.
7. Disposable items such as sphygmomanometer cuff and pillow should be considered, especially during the outbreak.
Terminal disinfection
1. Once the patients leave the environment, they should carry out terminal disinfection, clean first and then disinfect all the places that the patients and medical staff may touch.
2. If any non-contact disinfection (such as gaseous hydrogen peroxide or ultraviolet) is used, it should be fully cleaned before it.
3. If patients need medical examination or operation, they should be ranked last on the day, and the environment is clean as mentioned above.
Cleaning and disinfection of equipment
1. All equipment should be cleaned according to the manufacturer's instructions.
2. Special attention should be paid to the cleaning and disinfection of reused instruments, such as pulse oximeter, thermometer probe, etc.
Waste and fabric disposal
1. Pay attention to reasonable packaging to avoid environmental pollution by wastes and fabrics.
2. In pediatrics and neonatology, we should pay attention to the correct disposal of used diapers.
3. Do not discard or clean contaminated articles in the sink at any time.
The main reason why the "super fungus" infection caused such a large group panic is that it hit the most worrying part of all people.
Of course, in the process of transmission, some important information has been intentionally or unintentionally ignored - this is an ancient pathogen, which will not affect ordinary people, and the strains found in China are sensitive to drugs, etc. This part needs timely follow-up publicity from the media and professionals, as well as the spread of all of us.
Although we should not panic too much, this incident also reminds us that the consequences of antibiotic abuse have begun to show, and the outbreak of Candida auratus in the United States has alarmed us.