Antimicrobial resistance and multi-drug resistant organisms (MDROs), such as Candida auris (C auris), present challenges in hospital settings, contributing to high morbidity and mortality. A recent study presented at IDWeek explored advanced photohydrolysis (AP) technology to reduce microbial load in hospital units with active C auris infections. The findings demonstrated that AP technology can effectively reduce environmental bioburden in high-risk areas like hospital floors without requiring additional labor or resources.
In our interview with Deborah Birx, MD, chief scientific and medical advisor, and Amy Carenza, BBA, chief commercial officer at ActivePure Technologies, the two discussed how their AP technology reduced C auris and other pathogens in hospital settings.
Birx elaborated on factors that might explain the variability in C auris reduction despite significant decreases in fungal and aerobic bacteria colony-forming units (CFUs), noting, “By the time we came in, some patients were already shedding and infected with C auris, so the rooms had both colonization and active cases. In rooms where there were no active cases, we saw a dramatic decline in the fungal burden. But even in rooms with active cases, there was still a reduction.”
Carenza continued, offering insight into the dynamics of pathogen fluctuations, “If we continued taking measurements, we’d likely see that, after 30 days, those spikes would decline. This suggests we’re dealing with some sort of acute increase. However, what we’ve never seen is a return to baseline levels of contamination.”
Birx further emphasized the potential of the technology in preventing infections and their secondary complications, “Prevention never gets enough information, but we have a technology that is actually going to prevent all of those sequelae that we’re studying so aggressively, HAI and bacterial resistance, and Candida auris and these difficulties that we’re having, why don’t we just stop them from happening?”
Study Results and Design
The results showed a 99% reduction in floor fungal CFUs (p=0.011) and a 98% reduction in aerobic bacteria. Although C auris CFUs decreased by 66%, this reduction was not statistically significant. These findings suggest that while AP technology effectively reduces certain pathogens, additional environmental factors may influence its impact on C auris.
Conducted from September 2023 to January 2024, the study assessed the effect of AP technology on floor CFUs of aerobic bacteria, fungi, and C auris in a high-acuity hospital unit. Samples were collected before shift changes and daily cleaning by environmental services.
Impact on Patient Outcomes
Carenza discussed how AP technology could improve patient outcomes in high-acuity healthcare settings, “What excites me is that the nature of our technology, which is integrated into the environment, allows us to continue learning and gathering data. It also helps us show the world that we are standing the test of time. This technology works around the clock—24/7—behind the scenes. It makes any environment it’s in naturally more resilient to infections.”
Birx added, “What this technology offers is the possibility for every patient to not just survive, but to thrive. It prevents the complications that come with the treatments needed to save their lives. People can come into the hospital, get the care they need for the reason they came in, and avoid additional complications. They don’t just get through it, they can leave the hospital and go home able to thrive.”
Reducing Pathogens on High-Touch Surfaces
In addition to floor surfaces, high-touch surfaces in patient rooms showed a reduction in microbial load. Aerobic bacteria decreased by 82%, fungi by 99%, and C auris was eradicated from high-touch surfaces by Post-Activation #3. Although a slight increase in C auris was observed by Post-Activation #4, corresponding with the presence of active infections in some rooms. Despite this, the sample locations tested below 500 CFU/cm², a threshold associated with a lower risk of infection.
Challenges and Overcoming Skepticism
Birx reflected on the challenges ActivePure faced introducing the technology, particularly during the COVID-19 pandemic, “To be honest, I think the biggest challenge we faced came during COVID. A lot of technologies were introduced that hadn’t been properly tested. This led to a lot of skepticism, and people started to group all technologies like ours together, assuming they were all the same.”
Carenza added, “While it wasn’t necessarily pleasant to be doubted, it forced us to apply a level of rigor in inspecting our own technology. And now, looking at where we stand, I don’t see many other infection prevention technologies with the kind of data compendium we have. At the time, it felt like we had to grind through all that skepticism, but now we can see the results of that effort.”
Overall, this highlights ActivePure’s dedicated commitment to researching and developing a solution. These findings suggest that AP technology could serve as an effective complement to current infection control practices, helping to reduce environmental reservoirs of MDROs in hospitals.
