Der Klebsiella pneumoniae KPC-3 Ausbruch am Universitätsklinikum Frankfurt am Main: Eine Bestandsaufnahme aus krankenhaushygienischer Sicht

Impact of surface disinfection with hydrogen peroxide on the prevalence of vancomycin-resistant enterococci (VRE) in hospital wards

“…In June 2017, however, the environmental disinfectant procedure changed from glucoprotamin to H 2 O 2 -containing cleaning wipes in three intensive care units (Figure 1 (Fig. 1) ), which resulted from the management of an outbreak at UHF [ 18 ]. Afterwards, the VRE prevalence in environmental material sharply declined to 8.1% in 2018 and 2.6% in 2019 (as of 30 June 2019; Figure 2 (Fig.…”

“…Therefore, one or possibly a combination of factors is suggested to be responsible for this trend. In the phase immediately following the change and in the aftermath of outbreak management at UHF in spring 2017 [ 18 ], we propose that the observed decline of VRE prevalence was due to the Hawthorne effect , which might have led to behavioral changes among staff involved in infection control interventions and might thus have encouraged this trend [ 25 ], [ 26 ], [ 27 ]. As shown in other infection control studies, however, this effect is only temporary [ 27 ], [ 28 ], [ 29 ], indicating that the VRE prevalence in environmental samples at UHF might be due to additional factors.…”

“…In June 2017, environmental cleaning procedures underwent a major change on three wards at UHF: one surgical ICU (ward 1), one internal medicine ICU (ward 2) and one surgical intermediate care unit (ward 3). This change was a result of outbreak management of K. pneumoniae with carbapenem resistance at UHF in spring 2017 [ 18 ]. Ward environmental cleaning procedures during T1 were performed using the antimicrobial disinfectant glucoprotamin (Incidin TM Plus Wipes, Ecolab, Monheim am Rhein, Germany) for surface disinfection.…”

“…This evaluation is based on the results from rectal screening materials obtained from gastroenterological patients admitted to ward 2 in the 12 weeks prior to the outbreak of K. pneumoniae with carbapenem resistance at UHF in spring 2017 (T1; January 2017 to March 2017; [ 18 ]) as well as the 12 weeks following the completion of outbreak management (T2; June 2017 to August 2017). These patient groups and the periods were chosen for several reasons.…”

“…These tutorials also address basic infection control strategies, e.g., hand hygiene, cleaning and disinfection procedures for patients’ and wards’ inanimate environments, which have been shown to play a key role in the spread of MDRO [ 13 ], [ 14 ], [ 15 ], [ 16 ], [ 17 ]. A small outbreak at UHF (five patients affected) of Klebsiella pneumoniae with carbapenem resistance in spring 2017 [ 18 ] impelled a change from glucoprotamin to H 2 O 2 -containing wipes for surface disinfection. This resulted in a continuous decline of VRE prevalence in material obtained from ICU environmental sites at UHF.…”