Is Three Cloths for Each Patient Zone More Effective than One Cloth to Remove Multidrug-Resistant Organisms on High-touch Surfaces in General Intensive Care Unit?
OBJECTIVE.Contaminated environmental surfaces are an important source for transmission of Multidrug-Resistant Organisms(MDROs).Effective cleaning of surfaces within hospital rooms is necessary to prevent transmission.We investigated the effects of sequential enhanced cleaning measures by culturing high-touch surfaces in a general intensive care unit(GICU).METHODS.A prospective controlled,quasi-experimental study was conducted during a 17-month period in the 25-bed GICU.The study comprised a baseline period(period 1)and 4 sequential tiered interventions periods: each patient zone was wiped with one clean microfiber cloth daily(period 2),fluorescent markers and adenosine triphosphate(ATP)assay were used to monitor and feedback the effectiveness of cleaning(period 3),wiping one patient zone with three clean microfiber cloths daily(period 4)and withdrawal of the feedback from fluorescent markers and ATP assay(period 5).Methicillin-resistant staphylococcus aureus(MRSA),extended-spectrum β-lactamase(ESBL)-producing enterobacteriaceae and vancomycin-resistant enterococci(VRE)were used as marker organisms.Cultures of environmental samples from high-touch surfaces were performed.RESULTS.Compared to period 1,the mean percentages of MDROs positive cultures from high-touch surfaces was reduced by 41.0%(prevalence ratio(OR)=0.59 ”95%confidence interval(CI),0.46-0.77”,P<0.001),70.8%(OR=0.29,95%CI,0.20-0.43,P<0.001),82.6%(OR=0.17,95%CI,0.12-0.26,P<0.001)and 70.8%(OR=0.29,95%CI,0.21-0.39,P<0.0001)in period 2,3,4 and 5 respectively.Relative to one cloth for a patient zone,wiping each patient zone with three cloths resulted in a statistically significant 41.6%(OR=0.56,95%CI,0.34-0.91;P=0.018)and 50.5%(OR=0.58,95%CI,0.42-0.80;P=0.001)decrease in the prevalence of MDROs positive cultures with or without fluorescent markers and ATP assay.CONCLUSIONS.Enhanced cleaning reduced environmental contamination and using three cleaning cloths for one patient zone was more effective in ensuring effective cleaning of high-touch surfaces when compared to one cleaning cloth.
Environmental cleaning Multidrug-resistant organisms Microfiber cloth Intensive care unit
Tieer Gan Hong Xu Jiannong Wu Yuexian Zhu Lanfang Wang Hui Jin Lingya Wei Linhai Shen Xiaoping Ni Junmin Cao
Department of Hospital Infection Control,the First Affiliated Hospital of Zhejiang Chinese Medicine Department of Disinfection Surveillance and Vector Control,Center for Disease Control of Hangzhou,Ha General Intensive Care Unit,the First Affiliated Hospital of Zhejiang Chinese Medicine University,Ha
国内会议
中华预防医学会第25次全国医院感染学术年会暨第12届上海国际医院感染控制论坛(SIFI2016)联合会议
江苏苏州
英文
1-26
2016-06-01（万方平台首次上网日期，不代表论文的发表时间）