Patient shoe covers: Transferring bacteria from the floor onto surgical bedsheets

Galvin, Justin; Almatroudi, Ahmad; Vickery, Karen; Deva, Anand K.; Lopes, L.K.O.; Costa, Dayane de Melo; Hu, Honghua

doi:10.1016/j.ajic.2016.03.020

Cited by 15 publications

(7 citation statements)

References 8 publications

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“…These findings build upon a growing body of evidence suggesting that floors might be an underappreciated source of pathogen dissemination not addressed by current control measures. 2,[9][10][11][12][13] The fact that pathogens were recovered from the socks of patients suggests that one route of transfer may involve movement from socks to bedding or hands with subsequent transfer to hightouch surfaces by hands. The simulations with bacteriophage MS2 demonstrate the feasibility of this mechanism of transfer, either from socks directly to hands during sock removal or from socks to bedding and then to hands.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] Finally, some recent studies have suggested that floors might be an underappreciated source of pathogen transmission. [9][10][11][12][13] For example, a nonpathogenic virus inoculated onto floors in patient rooms disseminated rapidly to the hands of patients and to surfaces in the room. 9 To develop effective control measures, a better understanding of sources of pathogen exposure in healthcare facilities is needed.…”

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confidence: 99%

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Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

Redmond

Pearlmutter

Ng-Wong

et al. 2021

Infect. Control Hosp. Epidemiol.

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Objective: To investigate the timing and routes of contamination of the rooms of patients newly admitted to the hospital. Design: Observational cohort study and simulations of pathogen transfer. Setting: A Veterans’ Affairs hospital. Participants: Patients newly admitted to the hospital with no known carriage of healthcare-associated pathogens. Methods: Interactions between the participants and personnel or portable equipment were observed, and cultures of high-touch surfaces, floors, bedding, and patients’ socks and skin were collected for up to 4 days. Cultures were processed for Clostridioides difﬁcile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Simulations were conducted with bacteriophage MS2 to assess plausibility of transfer from contaminated floors to high-touch surfaces and to assess the effectiveness of wearing slippers in reducing transfer. Results: Environmental cultures became positive for at least 1 pathogen in 10 (59%) of the 17 rooms, with cultures positive for MRSA, C. difficile, and VRE in the rooms of 10 (59%), 2 (12%), and 2 (12%) participants, respectively. For all 14 instances of pathogen detection, the initial site of recovery was the floor followed in a subset of patients by detection on sock bottoms, bedding, and high-touch surfaces. In simulations, wearing slippers over hospital socks dramatically reduced transfer of bacteriophage MS2 from the floor to hands and to high-touch surfaces. Conclusions: Floors may be an underappreciated source of pathogen dissemination in healthcare facilities. Simple interventions such as having patients wear slippers could potentially reduce the risk for transfer of pathogens from floors to hands and high-touch surfaces.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

Redmond

Pearlmutter

Ng-Wong

et al. 2021

Infect. Control Hosp. Epidemiol.

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“…Shoes and shoe covers subsequently become contaminated and these microorganisms can then be transferred from patient to bed sheets or to hands when shoe covers are removed. 284,285 Shoe covers can be replaced by ordinary shoes dedicated exclusively to the operating theatre because no significant difference was found in floor contamination whether personnel wear shoe covers or dedicated theatre shoes. These shoes must be easy to wash.…”

Section: Rationalementioning

confidence: 99%

Guidelines for infection control and prevention in anaesthesia in South Africa

2021

Southern African Journal of Anaesthesia and Analgesia

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“…High-level disinfection of shoes is difficult and, in most cases, incompatible with the composition of the shoes [ 4 ], mainly due to the relative lack of consistent efficacy in decontaminating shoe soles using chemical or non-chemical strategies [ 27 ]. Sticky rugs for operating rooms have been discouraged [ 28 ], and disposable shoe protectors can lead to even greater contamination of the environment and hands [ 29 ]. Shoe covers are removed by healthcare workers’ hands, leading to contamination of their hands that were likely free of pathogens [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

“…Sticky rugs for operating rooms have been discouraged [ 28 ], and disposable shoe protectors can lead to even greater contamination of the environment and hands [ 29 ]. Shoe covers are removed by healthcare workers’ hands, leading to contamination of their hands that were likely free of pathogens [ 29 ]. Certainly, an effective disinfection strategy for shoe soles is urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness Evaluation of a UV-C-Photoinactivator against Selected ESKAPE-E Pathogens

Rangel

Cabral

Lechuga

et al. 2022

IJERPH

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Healthcare-associated infections (HAI) worldwide includes infections by ESKAPE-E pathogens. Environmental surfaces and fomites are important components in HAI transmission dynamics, and shoe soles are vectors of HAI. Ultraviolet (UV) disinfection is an effective method to inactivate pathogenic microorganisms. In this study, we investigated whether the SANITECH UV-C shoe sole decontaminator equipment that provides germicidal UV-C radiation could effectively reduce this risk of different pathogens. Six standard strains and four clinical MDR strains in liquid and solid medium were exposed to a UV-C System at specific concentrations at other times. Bacterial inactivation (growth and cultivability) was investigated using colony counts and resazurin as metabolic indicators. SEM was performed to assess the membrane damage. Statistically significant reduction in cell viability for all ATCCs strains occurred after 10 s of exposure to the UV-C system, except for S. enterica, which only occurred at 20 s. The cell viability of P. aeruginosa (90.9%), E. faecalis and A. baumannii (85.3%), S. enterica (82.9%), E. coli (79.2%) and S. aureus (71.9%) was reduced considerably at 20 s. In colony count, after 12 s of UV-C exposure, all ATCC strains showed a 100% reduction in CFU counts, except for A. baumannii, which reduced by 97.7%. A substantial reduction of colonies above 3 log10 was observed at 12 and 20 s in all bacterial strains tested, except for A. baumannii ATCC 19606 (12 s). The exposure of ATCCs bacterial strains to the UV-C system for only 2 s was able to reduce 100% in the colony forming units (CFU) count in all ATCCs strains, S. aureus, P. aeruginosa, E. coli, A. baumannii, E. faecalis, except the S. enterica strain which had a statistically significant reduction of 99.7%. In ATCC strains, there was a substantial decrease in colonies after 4 s (sec) of exposure to the UV-C system, with a reduction ranging from 3.78–4.15 log10 CFU/mL. This reduction was observed in MDR/ESKAPE-E strains within 10 s, showing that UV-C could eliminate above 3.84 log10 CFU/mL. SEM showed a reduction of pili-like appendages after UV-C treatment in all strains except for E. coli (ATCC 25922). The Sanitech UV-C shoe sole decontaminator equipment from Astech Serv. and Fabrication Ltd. (Petrópolis, Brazil), effectively killed in vitro a series of ATCCs and MDR/ESKAPE-E bacteria of sanitary interest, commonly found in the hospital environment.

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Patient shoe covers: Transferring bacteria from the floor onto surgical bedsheets

Cited by 15 publications

References 8 publications

Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

Guidelines for infection control and prevention in anaesthesia in South Africa

Effectiveness Evaluation of a UV-C-Photoinactivator against Selected ESKAPE-E Pathogens

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