Noting that the spread of mucormycosis is becoming a cause of concern, the Centre has advised all states and union territories to review their preparedness for prevention and control of fungal infections as well as hygiene and sanitation in hospitals.

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In recent days, some states and UTs have reported an increasing number of patients suffering from mucormycosis, commonly known as black fungus. The Union Health Secretary has written to the Chief Secretaries and Administrators of all states and UTs, urging them to undertake activities/ practices to ensure that there are robust infection prevention and control practices in COVID-19 hospitals and other healthcare facilities. In his letter, he advised them to establish/activate the Hospital Infection Control Committee with the head of the institution or an administrator as the chairperson, designate an infection prevention and control nodal officer -- preferably a microbiologist or senior infection control nurse. He also asked them to prepare and implement the Infection Prevention Control (IPC) Programme in the hospital/health facilities, as per the guidance given in National Guidelines for Infection and Control in Healthcare Facilities.

Transmission-based precautions need heightened focus on droplet, airborne and contact precautions from the perspective of protecting healthcare workers and ensuring patient safety, he said in the letter. Besides, the letter stressed on the improving the environment and facilitate ventilation with focus on fresh air and natural ventilation wherever control systems with requisite air changes are not available, cleaning, disinfection and sanitation of the hospital environment and frequently touched surfaces, with recommended disinfectants like 1% sodium hypochlorite or 70% alcohol and safe water and food to prevent water or food borne diseases in hospital settings .

The letter stated that biomedical waste needs to be managed as per the CPCB guidelines available and that Infection Prevention and Control practices needs to be enhanced in Intensive Care Units (ICUs) using a bundle-approach to prevent device associated infections such as ventilator associated pneumonia or catheter-associated blood stream, urinary infections etc.

Infection prevention and control practise in the clinical laboratories and those attached to hospitals are very crucial for the safety of laboratory/hospital staff and health security of the community, the letter stated. Meticulous adherence to infection prevention and control while managing immunocompromised patients such as COVID-19 patients on steroid treatment, with co-morbidities (such as diabetes where good glycemic control needs to be established), the letter underlined.

In due course, establish surveillance of healthcare associated infections with focus on ventilator associated pneumonia, catheter-associated blood stream infection, catheter-associated urinary tract infection, surgical site infections, gastro-intestinal outbreaks. Train all hospital staff to develop their skills in IPC, irrespective of their individual routine duties, in implementing procedures and protocols described in the Hospital Infection Control Manual. A State Nodal Officer needs to be identified to monitor the implementation of infection prevention and control to provide evaluation and feedback of the IPC programme in the state.