Hosps ramp up hygiene measures, keep close watch to prevent mucormycosis

Nagpur: Hospitals witnessing rise in cases of mucormycosis caused by black fungus among Covid recovered patients are adopting a slew of precautionary measures, clinically and hygienically, to tackle the disease.
The hospitals, despite many of them having own team, are planning to rope in experts to meet the rush expected in the coming days.
Going by the theory of ‘hospital acquired’ infection of mucormycosis among Covid patients by ‘opportunistic fungal spores’, the hospital managements and the clinicians are using ‘dry oxygen’ and air purifiers, keeping close watch on sugar levels and using steroids ‘judiciously’ .
Dr Anup Marar, one of the directors of Orange City Hospital Research Institute, said their administration is using methylene blue for oxygen humidifiers bottles and isotonic saline nasal washes twice daily for all admitted Covid patients. “Our clinical team is keeping strict vigil on the blood sugar level along with austere use of steroids,” he said.
Dr Jay Deshmukh of Sunflower Hospital said all patients and staffs have been strictly advised to wear double masks. “We are ensuring the patients perform Betadine gurgles. Close watch is being kept on whether the blood sugar level is within prescribed limit and diabetic patients are put on insulin,” he said.
“The patients are getting infections at home and not hospitals,” said Dr Deshmukh and added, “Besides our own team, we also have additional experts on panel who can provide their service on calls.”
According to Niranjan Joshi, spokesperson, Alexis Multispecialty Hospital, ‘dry oxygen’ is being used because water is one of the reasons behind mucormycosis. “We have centralized unit from where oxygen is supplied to the patients. There is a stringent protocol in place to ensure ‘proper air exchange’ at the premises to ensure the right balance of humidity is maintained. We have proper and timely monitoring and maintenance of air handling unit (AHU) to maintain right air exchange,” said Joshi.
“We only use disposal tubing for nasal oxygen supply and environmental rounds are undertaken twice a month to maintain high standard of hygiene,” he said.
He also said clinicians are following strict sugar control and appropriate use of steroids. “We also keep a high degree of suspicion while treating for early detection of mucormycosis by our infection disease specialist,” said Joshi.
Dr Vaibhav Agrawal, consultant internal medicine and core member of the Covid care team of Wockhardt hospital, said the bio-medical team of their institution ensures high standard of air quality and used distilled water humidifiers. “Clinically, we ensure the blood ferritin level and sugar are kept under close surveillance as both of these are conducive for the growth of the mucormycosis,” said Dr Agrawal.
“If we use immunosuppressant drugs like Tocilizumab, then we ensure the antifungal medicines are given as prophylactic,” he said.
Dr Avinash Gawande, medical superintendent of Government Medical College and Hospital (GMCH), said the in-charge of oxygen ensures the ports are cleaned frequently and after use. “GMCH already has a distilled water plant from where the humidifiers or the oxygen flowmeters are filled,” he said.