Environmental contamination by multidrug-resistant microorganisms after daily cleaning

Gavaldà, Laura; Pequeño, Sandra; Soriano, Ana; Domı́nguez, M.A.

doi:10.1016/j.ajic.2015.03.009

Cited by 23 publications

(15 citation statements)

References 8 publications

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“…The median contact rate on all fomites by HCWs was 37.8 contacts per hour, which is lower than the 93.1 contacts per hour reported by Cheng et al [9]. As many of these surfaces have been found to be contaminated with respiratory viruses and multidrug-resistant bacteria [5][6][7]14], transmission via environmental surfaces is very plausible. The number of contacts by HCWs with patients and fomites and the performance of respiratory care activities have been associated with bacterial contamination on the gloves and hands of HCWs after patient care [15,16].…”

Section: Discussionmentioning

confidence: 69%

Environmental Contact and Self-contact Patterns of Healthcare Workers: Implications for Infection Prevention and Control

Phan

Maita

Mortiz

et al. 2019

Clinical Infectious Diseases

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Background Respiratory viruses on fomites can be transferred to sites susceptible to infection via contact by hands or other fomites. Methods Care for hospitalized patients with viral respiratory infections was observed in the patient room for 3-hour periods at an acute care academic medical center for over a 2 year period. One trained observer recorded the healthcare activities performed, contacts with fomites, and self-contacts made by healthcare workers (HCWs), while another observer recorded fomite contacts of patients during the encounter using predefined checklists. Results The surface contacted by HCWs during the majority of visits was the patient (90%). Environmental surfaces contacted by HCWs frequently during healthcare activities included the tray table (48%), bed surface (41%), bed rail (41%), computer station (37%), and intravenous pole (32%). HCWs touched their own torso and mask in 32% and 29% of the visits, respectively. HCWs’ self-contacts differed significantly among HCW job roles, with providers and respiratory therapists contacting themselves significantly more times than nurses and nurse technicians (P < .05). When HCWs performed only 1 care activity, there were significant differences in the number of patient contacts and self-contacts that HCWs made during performance of multiple care activities (P < .05). Conclusions HCWs regularly contact environmental surfaces, patients, and themselves while providing care to patients with infectious diseases, varying among care activities and HCW job roles. These contacts may facilitate the transmission of infection to HCWs and susceptible patients.

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Section: Discussionmentioning

confidence: 69%

Environmental Contact and Self-contact Patterns of Healthcare Workers: Implications for Infection Prevention and Control

Phan

Maita

Mortiz

et al. 2019

Clinical Infectious Diseases

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“…There are numerous examples of contaminated cleaning cloths and equipment that spread microbes across surfaces rather than removing them [17][18][19][20][21][22]. This has encouraged disinfectant use, which kills pathogens but can be expensive and environmentally unfriendly [23,24].…”

Section: Novel Disinfectantsmentioning

confidence: 99%

Dos and don’ts for hospital cleaning

Dancer

2016

Current Opinion in Infectious Diseases

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Purpose of review More evidence is emerging on the role of cleaning and decontamination for reducing hospital-acquired infection. Timely and adequate removal of environmental pathogens leads to measurable clinical benefits for patients. This article considers studies published from 2013 examining hospital decontamination technologies and evidence for cost-effectiveness. Recent findings Novel biocides and cleaning products, antimicrobial coatings, monitoring practices and automated equipment are widely accessible. They do not necessarily remove all environmental pathogens, however, and most have yet to be comprehensively assessed against patient outcome. Some studies are confounded by concurrent infection control and/or antimicrobial stewardship initiatives. Few contain data on costs. Summary As automated dirt removal is assumed to be superior to human effort, there is a danger that traditional cleaning methods are devalued or ignored. Fear of infection encourages use of powerful disinfectants for eliminating real or imagined pathogens in hospitals without appreciating toxicity or cost benefit. Furthermore, efficacy of these agents is compromised without prior removal of organic soil. Microbiocidal activity should be compared and contrasted against physical removal of soil in standardized and controlled studies to understand how best to manage contaminated healthcare environments.

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“…In contrast, nonsignificant reductions of MDRO detection after cleaning mostly involved surfaces that received contact from patients, family members, and accompanying staff. A study by Gavalda et al 18 suggested that 13.8 hours after routine cleaning and disinfection, 53.8% of frequently touched objects on patient wards exhibited MDRO colonization. Therefore, environmental cleaning measures should include greater emphasis on hand hygiene among patients and family members; the frequency of cleaning and disinfection should be greater for surfaces that receive contact from patients than for surfaces that receive contact from medical personnel.…”

Section: Discussionmentioning

confidence: 99%

Impact of multicenter unified enhanced environmental cleaning and disinfection measures on nosocomial infections among patients in intensive care units

et al. 2020

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Objectives Most Chinese hospitals have customized environmental cleaning policies and systems, with limited data availability based on evidence-based medicine. This study investigated the relationship between multidrug-resistant organism (MDRO) colonization in intensive care unit (ICU) patients and ICU surface bacterial contamination status. Methods This cross-sectional study comprised MDRO screening in ICU patients using bacterial cultivation by chromogenic medium; samples were collected before (control group) and after implementation of enhanced cleaning (cleaning group). Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to identify and analyze microorganisms; the relationships of MDRO colonization with infection and environmental bacteria were analyzed. Results In total, 196 patients were enrolled in the study (104 and 92 in control and cleaning groups, respectively); 1042 MDROs were subjected to screening before and after cleaning. After cleaning, the rate of MDRO detection on surfaces of frequently touched objects in ICUs decreased from 31.77% to 13.32%. There were fewer MDRO homologues in the cleaning group than in the control group. Moreover, the cleaning group had a shorter ICU stay and significantly lower mortality rate. Conclusions Enhanced environmental cleaning and disinfection could reduce environmental MDRO accumulation and suppress MDRO colonization in ICUs, thereby reducing nosocomial infections and improving adverse patient outcomes.

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Environmental contamination by multidrug-resistant microorganisms after daily cleaning

Cited by 23 publications

References 8 publications

Environmental Contact and Self-contact Patterns of Healthcare Workers: Implications for Infection Prevention and Control

Environmental Contact and Self-contact Patterns of Healthcare Workers: Implications for Infection Prevention and Control

Dos and don’ts for hospital cleaning

Impact of multicenter unified enhanced environmental cleaning and disinfection measures on nosocomial infections among patients in intensive care units

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