Last month, the Society for Healthcare Epidemiology of America (SHEA) held its first in-person conference in over two years. Over 1,100 attendees from 24 countries participated in-person or online and included members and non-members of all disciplines relating to Infection Prevention Programs, Antibiotic Stewardship Programs, Public Health, Pharmacy, Occupational Health, Clinical Microbiology, Quality Improvement, and Patient Safety.
As with previous years, the SHEA Spring conference consisted of:
- Two training courses:
- SHEA/CDC Training Course in Healthcare Epidemiology
- SHEA Antibiotic Stewardship Training Course
- General conference sessions focused on innovative topics in Healthcare Epidemiology and Antibiotic Stewardship
- New research abstracts related to healthcare, surveillance, epidemiology, patient safety and infection prevention strategies
Notably, COVID-19 was not a main focus of this year’s conference. Presenters shared research that examined the unintended consequences and lessons learned from the pandemic, but it was unmistakable that our collective focus has shifted to identifying, predicting, and hopefully, preventing the next global pandemic. One of the most fascinating talks was a Plenary Session given by Dr. Ali S. Khan and Dr. Tom Chiller on Climate Change and the Emergence of Novel Pathogens in Healthcare. Former Director of the Office of Public Health and retired Assistant Surgeon General, Dr. Khan highlighted that we are in a bit of a perfect storm scenario with (1) climate change, (2) stress on healthcare infrastructure, and (3) the spread of new pathogens in healthcare settings before they are identified. His best guess was that our next pandemic is likely to be viral in nature with some top candidates being Influenza A and other Coronaviruses.
Similarly, Dr. Chiller, who is currently the Chief of the Mycotic Diseases Branch at the Centers for Disease Control and Prevention (CDC) agreed that we are undoubtedly in the “viral era,” but that fungi is the future and potentially on a path to be the source of the next deadly plague. Dr. Chiller cited that this is because fungi are inherently sensitive to environmental and climate change. He went on to explain that this theory is well supported and illustrated by the emergence of Candida auris. C. auris was first identified in 2009 and by 2018 was labeled an urgent threat by the CDC. As of 2022, it has now been found on every populated continent, including North America and the United States.1 It appears to prefer warm, salty conditions and in many ways behaves more like a bacteria than a yeast because it:
- Demonstrates resistance to antifungals
- Thrives on skin (and surfaces!)
- Contaminates patient rooms
- Spreads in healthcare settings
For all the above reasons, a robust cleaning and disinfection protocol is critical when C. auris has been identified at your facility. Currently, the CDC recommends use of a disinfectant that is registered with the Environmental Protection Agency (EPA) and is effective against C. auris. If a product with an EPA claim is not available, the CDC recommends using a disinfectant that is effective against C. difficile (see EPA List K).2 Disinfectants with an EPA claim for C. difficile have been used effectively against C. auris.
Ultimately, Drs. Khan and Chiller made clear that we can no longer separate global health and climate change from our work in public health and infection prevention. The good news is that important research is already underway. One example is CDC’s ONE HEALTH. One Health “is a collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants and their shared environment.” You can learn more at https://www.cdc.gov/onehealth/.
1. General Information about Candida auris. Centers for Disease Control and Prevention website. https://www.cdc.gov/fungal/candida-auris/candida-auris-qanda.html Updated 2019. Accessed March 24, 2022.
2. Infection Prevention and Control for Candida auris. Centers for Disease Control and Prevention website. https://www.cdc.gov/fungal/candida-auris/c-auris-infection-control.html Updated 2021. Accessed March 24, 2022.