Infection Control & Hospital Epidemiology
Table 1. Germicidal Activity Against Candida auris and Candida albicans Using a Quantitative Carrier Test Method Germicide name
Manufacturer, Location
Purell Advanced instant hand sanitizer
Betadine solution
Medicated Soft ‘N Sure Soft Care Defend Avagard
Scrub-Stat 2% Scrub-Stat 4%
Isopropyl rubbing alcohol 70% USP
Solution of hydrogen peroxide 3% USP
GOJO, Akron, OH
Purdue Products, Stamford, CT
Steris, St. Louis, MO Diversey, Charlotte, NC 3M, St Paul, MN
Active Ingredient 70% ethanol
10% povidone–iodine/1% iodine 0.5% triclosan 1% chloroxylenol
1% chlorhexidine gluconate solution, 61% ethyl alcohol
Formulation Tested
Undiluted Undiluted
Undiluted Undiluted Undiluted
Ecolab, St Paul, MN 2% chlorhexidine gluconate solution Undiluted Ecolab, St Paul, MN 4% chlorhexidine gluconate solution Undiluted
Medichoice, Mechanicsville, VA
Medichoice, Mechanicsville, VA
Austin’s A-1 bleach 1:10 James Austin Co, Mars, PA
Austin’s A-1 bleach 1:50 James Austin Co, Mars, PA
Vesphene IIse
Hydrogen peroxide cleaner disinfectant
Lysol disinfectant spray
A-456 II disinfectant cleaner
Super Sani-Cloth wipe Prime Sani-Cloth wipe
S40 sterilant concentrate S4000
Cidex-OPA Cidex Oxycide Revital-Ox Resert Steris, St Louis, MO Clorox, Oakland, CA
Reckitt Benckiser, Parsippany, NJ
Ecolab, St Paul, MN 70% isopropyl alcohol 3% hydrogen peroxide
5.25% sodium hypochlorite (∼6,100–6,700 ppm)
5.25% sodium hypochlorite (∼1,245 ppm)
9.09% o-phenylphenol, 7.66% p-tertiary amylphenol
1.4% hydrogen peroxide 58% ethanol, 0.1% QACb 21.7% QACc
PDI, Orangeburg, NY 55% isopropyl alcohol, 0.5% QACd PDI, Orangeburg, NY
28.7% isopropyl alcohol, 27.3% ethyl alcohol, 0.61% QACe
Steris, Mentor, OH
Advanced Steril Prod, Irvine, CA
Advanced Steril Prod, Irvine, CA
Ecolab, St Paul, MN Steris, Mentor, OH Note. QAC, quaternary ammonium compound.
aValues are shown in mean log10 reductions under a test condition of 104 test organisms with 5% fetal calf serum and 1 minute contact time. bQAC: alkyl (C14 50%, C12 40%, C16 10%) dimethyl benzyl ammonium saccharinate 0.1%. cQAC: octyl decyl dimethyl ammonium chloride 6.51%; dioctyl dimethyl ammonium chloride 2.604%; didecyl dimethyl ammonium chlorid 3.906%; alkyl (50%C14, 40% C12, 10% C16) dimethyl benzyl ammonium chloride 8.68%
dQAC: n-alkyl (C12 68%, C14 32%) dimethyl ethylbenzyl ammonium chlorides 0.25%; n-Alkyl (C14 60%, C16 30%, C12 5%, C18 5%) dimethyl benzyl ammonium chlorides 0.25%. eQAC: didecyl dimethyl ammonium chloride 0.61%. fExtract from cloth.
35% peracetic acid 0.55% ortho-phthalaldehyde 2.4% glutaraldehyde
27.5% hydrogen peroxide, 5.8% peroxyacetic acid
2% accelerated hydrogen peroxide Undiluted Undiluted 1:10 dilution 1:50 dilution 1:128 dilution Undiluted Undiluted 1:256 dilution
Undilutedf Undilutedf
0.20% Undiluted Undiluted 1:43 dilution Undiluted
Disinfectant Disinfectant
High-level disinfectant/ Chemical sterilant
High-level disinfectant
High-level disinfectant/ Chemical sterilant
High-level disinfectant/ Chemical sterilant
High-level disinfectant
3.9 4.1
4.1 2.3 4.1 4.1 4.1
4.1 4.1
4.1 3.8 4.1 4.1 4.1 Disinfectant Disinfectant Disinfectant 4.1 3.8 1.7 4.1 4.1 1.5
381
C.
Classification Antiseptic
Antiseptic
Antiseptic/Handwash Antiseptic/Handwash
Antiseptic/Surgical hand scrub
Antiseptic/Surgical hand scrub/handwash
Antiseptic/Surgical hand scrub/handwash
Antiseptic/Disinfectant Antiseptic Disinfectant Disinfectant Disinfectant
aurisa 4.0
2.5
1.4 2.8 2.0
1.6 1.9 3.8 1.4 4.1 1.6 4.1
C.
albicansa 2.5
2.3
1.7 3.9 1.9
2.8 3.5 4.1 1.8 4.0 1.5 3.6
registration claim>1minute (eg, 8–45 minutes). In summary, with the exception of a water-based QAC and a 1:50 dilution of sodium hypochlorite, our data demonstrate thatmost disinfectants (10 of 13, 77%) used in healthcare facilities are effective (>3-log10 reduction) against C. auris. Importantly, water-based QACs, which are com- monly used for surface disinfectants, had limited activity and there- fore should not be used for disinfection of environmental surfaces or
noncritical patient equipment in rooms housing patients with C. auris.10 In contrast, 7 of 9 antiseptics (78%) did not achieve a 3- log10 reduction of C. auris in 1 minute. Because C. auris can persist on surfaces in healthcare environ-
ments, cleaning and disinfecting the patient care environment (daily and discharge/terminal cleaning) with effective products is essential. The CDC has recommended the use of EPA-registered
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