From the Research
To disinfect the axilla of a patient with Candida auris, use chlorhexidine gluconate (CHG) 4% daily for bathing and axillary cleansing, as supported by the most recent study 1, which although shows limited decolonization efficacy, still supports the use of chlorhexidine in clinical practice.
Key Considerations
- Apply the solution with a clean cloth, allowing it to remain on the skin for at least 2 minutes before rinsing.
- For patients with extensive colonization, consider using CHG-impregnated wipes specifically for the axillary region.
- Ensure the area is completely dried after cleansing to prevent moisture accumulation.
- This should be performed daily as part of a comprehensive hygiene protocol.
Healthcare Worker Precautions
- Healthcare workers should wear appropriate personal protective equipment including gloves, gowns, and possibly masks when performing this procedure.
- C. auris is highly resistant to many disinfectants, but chlorhexidine has shown effectiveness against this pathogen, as demonstrated in earlier studies 2, 3, 4.
Environmental Cleaning
- Environmental cleaning of items that contact the axillary region is also crucial, using hospital-grade disinfectants with specific activity against C. auris, such as those containing hydrogen peroxide or sodium hypochlorite.
- The use of natural antiseptics like tea tree oil and manuka oil may also be considered, as they have shown antifungal efficacy against C. auris 4.
Important Notes
- While the most recent study 1 shows that daily bathing with 4% chlorhexidine plus daily cleaning with 4% chlorhexidine wipe for 1 week may not be very effective in decolonizing C. auris, it is still a recommended practice due to the lack of alternative effective methods.
- The study 5 also supports the use of chlorhexidine gluconate bathing program to reduce health care-associated infections in both critically ill and non-critically ill patients.