Surface microbial contamination in hospitals: A pilot study on methods of sampling and the use of proposed microbiologic standards

Claro, Tânia; O'Reilly, Marese; Daniels, Stephen; Humphreys, Hilary

doi:10.1016/j.ajic.2015.05.009

Cited by 22 publications

(29 citation statements)

References 9 publications

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“…In the context of bioaerosol exposure in healthcare facilities, humans are recognized sources of airborne fungal and bacterial species . Other recognized sources of microbial communities include fixed surfaces of rooms and furnishings, wastes, and various textiles, including beddings and hospital scrubs, but the relative contribution of each is unknown . Despite notable progress in infection control, through HEPA filtration of ventilation air, stringent surface cleaning, and strict hand‐washing policies, nosocomial infections remain a major concern.…”

Section: Resultsmentioning

confidence: 99%

Clothing as a transport vector for airborne particles: Chamber study

Licina

Nazaroff

2018

Indoor Air

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Strong evidence suggests that clothing serves as a reservoir of chemical pollutants and particles, including bioaerosols, which may have health significance. However, little is known about the role that clothing may play as a transport vector for inhaled airborne particles. Here, we contribute toward bridging the knowledge gap by conducting experiments to investigate clothing release fraction (CRF), determined as the size-dependent ratio of released to deposited particulate matter in the diameter range 0.5-10 μm. In a fully controlled chamber with low background particle levels, we deployed a programmable robot to reproducibly quantify the size-dependent CRF as a function of motion type and intensity, dust loadings, and activity duration. On average, 0.3%-3% of deposited particles were subsequently released with fabric motion, confirming that clothing can act as a vehicle for transporting airborne particles. The CRF increased with the vigor of movement and with dust loading. Rubbing and shaking the fabric were more effective than fabric stretching in resuspending particles. We also found that most of the release happened quickly after the onset of the resuspension activity. Particle size substantially influenced the CRF, with larger particles exhibiting higher values.

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Section: Resultsmentioning

confidence: 99%

Clothing as a transport vector for airborne particles: Chamber study

Licina

Nazaroff

2018

Indoor Air

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“…3–5,9,10,13 The few studies reporting quantitative results focus either on the amount of overall contamination or contamination by specific pathogens, usually not both. 14–21 Microbial bioburden (MB), when reported, is only from individual surfaces, such as bed rails, or is reported in relation to cleaning method or product efficacy testing. 21–26 These studies can be difficult to compare because they often use different sampling methodologies or reporting units.…”

mentioning

confidence: 99%

“…14–21 Microbial bioburden (MB), when reported, is only from individual surfaces, such as bed rails, or is reported in relation to cleaning method or product efficacy testing. 21–26 These studies can be difficult to compare because they often use different sampling methodologies or reporting units. 15,17,19–22,27 …”

mentioning

confidence: 99%

Assessment of the Overall and Multidrug-Resistant Organism Bioburden on Environmental Surfaces in Healthcare Facilities

Shams

Rose

Edwards

et al. 2016

Infect. Control Hosp. Epidemiol.

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OBJECTIVE To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning. DESIGN Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2). SETTING MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states. PARTICIPANTS Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms). METHODS Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room. Composite 1 included the TV remote, telephone, call button, and bed rails. Composite 2 included the room door handle, IV pole, and overbed table. Composite 3 included toileting surfaces. Total bacteria and MDROs (ie, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci [VRE], Acinetobacter baumannii, Klebsiella pneumoniae, and C. difficile) were quantified, confirmed, and tested for drug resistance. RESULTS The mean microbial bioburden and range from routine cleaned room composites were higher (2,700 colony-forming units [CFU]/100 cm2; ≤1-130,000 CFU/100 cm2) than from terminal cleaned room composites (353 CFU/100 cm2; ≤1-4,300 CFU/100 cm2). MDROs were recovered from 34% of routine cleaned room composites (range ≤1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (≤1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms; VRE was the most common (19%). CONCLUSIONS This multicenter bioburden summary provides a first step to determining microbial bioburden on healthcare surfaces, which may help provide a basis for developing standards to evaluate cleaning and disinfection as well as a framework for studies using an evidentiary hierarchy for environmental infection control. Infect Control Hosp Epidemiol 2016;1426-1432.

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“…This applies, in particular, to touch surfaces in hospital rooms. The quantitative level of touch surfaces contamination in hospital wards differs depending on the type of surfaces, type of wards or hygienic regimen in a specific unit [14,15]. The same applies to qualitative differences (bacterial, fungal or viral species).…”

Section: Introductionmentioning

confidence: 99%

Bacteria contamination of touch surfaces in polish hospital wards

Różańska¹,

Romaniszyn²,

Chmielarczyk³

et al. 2017

Med Pr

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Background: The objective of the study has been to evaluate the pathogenic bacteria contamination of touch surfaces in hospital wards. Material and Methods: Samples were taken from frequently touched surfaces in the hospital environment in 13 units of various types. Culturing was carried out on solid blood agar and in growth broth (tryptic soy broth -TSB). Species identification was performed using the analytical profile index (API) biochemical testing and confirmed with matrix assisted laser desorption ionization time-flight mass spectrometry (MALDI-TOF-MS) system. Results: The total of 161 samples were taken for the study. Fifty-two of them, after 24 h of culture on a solid medium, demonstrated bacterial growth and further 60 samples had growth after prior multiplication in TSB. Overall, 69.6% of samples exhibited growth of 19 bacterial species. Pathogenic species -representing indicator organisms of efficiency of hospital cleaning -was demonstrated by 21.4% of samples. Among them Acinetobacter spp., Enterocococci spp. and Staphylococcus aureus were identified. Coagulase-negative staphylococci (CNS) were predominant. The proportion of various groups of bacteria significantly varied in respective hospitals, and in various types of wards. Disturbing observation is a large proportion of resistance of isolated CNS strains as a potential reservoir of resistance genes. Conclusions:The results show that touch surfaces in hospital units are contaminated by both potentially pathogenic and pathogenic bacterial species. In connection with the reported, also in Poland, frequent omission or incorrect execution of hand hygiene by hospital staff, and probably patients, touch surfaces still constitute important reservoir of pathogenic bacteria. Improving hand hygiene compliance of health-care workers with recommendations is necessary for increasing biological safety of hospital environment. Med Pr 2017;68(4):459-467

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Surface microbial contamination in hospitals: A pilot study on methods of sampling and the use of proposed microbiologic standards

Cited by 22 publications

References 9 publications

Clothing as a transport vector for airborne particles: Chamber study

Clothing as a transport vector for airborne particles: Chamber study

Assessment of the Overall and Multidrug-Resistant Organism Bioburden on Environmental Surfaces in Healthcare Facilities

Bacteria contamination of touch surfaces in polish hospital wards

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