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Efficacy of manual cleaning and an ultraviolet C room decontamination device in reducing health care–associated pathogens on hospital floors

Published on Jan 1, 2018in American Journal of Infection Control1.971
· DOI :10.1016/j.ajic.2017.10.025
Aishat Mustapha2
Estimated H-index: 2
(Case Western Reserve University),
Heba Alhmidi6
Estimated H-index: 6
+ 2 AuthorsCurtis J. Donskey49
Estimated H-index: 49
(Case Western Reserve University)
Abstract
Recent studies suggest that floors may be an underappreciated source for transmission of health care–associated pathogens. However, there are limited data on the effectiveness of current cleaning and disinfection methods in reducing floor contamination. We demonstrated that manual postdischarge cleaning by environmental services personnel significantly reduced floor contamination, and an automated ultraviolet C room disinfection device was effective as an adjunct to manual cleaning.
  • References (10)
  • Citations (3)
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References10
Newest
#2Jennifer L. CadnumH-Index: 16
Last. Curtis J. Donskey (Case Western Reserve University)H-Index: 49
view all 6 authors...
Contaminated surfaces have been implicated as a potential route for dissemination of the emerging multidrug-resistant fungal pathogen Candida auris . In laboratory testing, C. auris and other Candida species persisted for 7 days on moist or dry surfaces. Candida species were recovered frequently from the hospital environment, particularly from moist surfaces. Infect Control Hosp Epidemiol 2017;38:1107–1109
55 CitationsSource
#1Abhishek Deshpande (Case Western Reserve University)H-Index: 27
#2Jennifer L. Cadnum (Case Western Reserve University)H-Index: 16
Last. Curtis J. Donskey (Case Western Reserve University)H-Index: 49
view all 10 authors...
In a survey of 5 hospitals, we found that floors in patient rooms were frequently contaminated with pathogens and high-touch objects such as blood pressure cuffs and call buttons were often in contact with the floor. Contact with objects on floors frequently resulted in transfer of pathogens to hands.
15 CitationsSource
#1Tasnuva RashidH-Index: 5
#2Helena M. VonVilleH-Index: 7
Last. Kevin W. GareyH-Index: 37
view all 4 authors...
6 CitationsSource
#2Curtis J. Donskey (Case Western Reserve University)H-Index: 49
Exposing Clostridium difficile spores to germinants in a quaternary ammonium matrix was an effective method to reduce environmental contamination by sensitizing the spores, leaving them susceptible to ambient conditions and enhancing killing by acid, high-intensity visible light, and radiation.
3 CitationsSource
Hospital floors are frequently contaminated with pathogens, but it is not known whether floors are a potential source of transmission. We demonstrated that a nonpathogenic virus inoculated onto floors in hospital rooms disseminated rapidly to the hands of patients and to high-touch surfaces inside and outside the room. Infect Control Hosp Epidemiol 2016;1–4
20 CitationsSource
#1Jennifer L. CadnumH-Index: 16
#2Myreen E. TomasH-Index: 10
Last. Curtis J. Donskey (Case Western Reserve University)H-Index: 49
view all 7 authors...
OBJECTIVE To determine the effect of variation in test methods on performance of an ultraviolet-C (UV-C) room decontamination device. DESIGN Laboratory evaluation. METHODS We compared the efficacy of 2 UV-C room decontamination devices with low pressure mercury gas bulbs. For 1 of the devices, we evaluated the effect of variation in spreading of the inoculum, carrier orientation relative to the device, type of organic load, type of carrier, height of carrier, and uninterrupted versus interrupted...
17 CitationsSource
#1Titus Wong (UBC: University of British Columbia)H-Index: 7
#2Tracey Woznow (Vancouver General Hospital)H-Index: 1
Last. Elizabeth Bryce (UBC: University of British Columbia)H-Index: 25
view all 7 authors...
Background Two ultraviolet-C (UVC)–emitting devices were evaluated for effectiveness in reducing methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile (CD). Methods Six surfaces in rooms previously occupied by patients with MRSA, VRE, or CD were cultured before and after cleaning and after UVC disinfection. In a parallel laboratory study, MRSA and VRE suspended in trypticase soy broth were inoculated onto stainless steel carriers in...
19 CitationsSource
#1Deverick J. Anderson (Duke University)H-Index: 47
#2Maria F. Gergen (UNC: University of North Carolina at Chapel Hill)H-Index: 20
Last. William A. Rutala (UNC: University of North Carolina at Chapel Hill)H-Index: 60
view all 7 authors...
objective.To determine the effectiveness of an automated ultraviolet-C (UV-C) emitter against vancomycin-resistantenterococci(VRE), Clostridium difficile, andAcinetobacterspp. in patient rooms. design.Prospective cohort study. setting.Two tertiary care hospitals. participants.Convenience sample of 39 patient rooms from which a patient infected or colonized with 1 of the 3 targeted pathogens had been discharged. intervention.Environmental sites were cultured before and after use of an automated U...
60 CitationsSource
#1Brett Sitzlar (Case Western Reserve University)H-Index: 10
#2Abhishek Deshpande (Case Western Reserve University)H-Index: 27
Last. Curtis J. Donskey (Case Western Reserve University)H-Index: 49
view all 6 authors...
Objective. Effective disinfection of hospital rooms after discharge of patients with Clostridium difficile infection (CDI) is necessary to prevent transmission. We evaluated the impact of sequential cleaning and disinfection interventions by culturing high-touch surfaces in CDI rooms after cleaning.Design. Prospective intervention.Setting. A Veterans Affairs hospital.Interventions. During a 21-month period, 3 sequential tiered interventions were implemented: (1) fluorescent markers to provide mo...
75 CitationsSource
#1Jennifer L. Cadnum (Case Western Reserve University)H-Index: 16
#2Kelly HurlessH-Index: 6
Last. Curtis J. Donskey (Case Western Reserve University)H-Index: 49
view all 4 authors...
20 CitationsSource
Cited By3
Newest
#1Patrick Murphy (MCV: VCU Medical Center)
#2Le Kang (MCV: VCU Medical Center)
Last. Gonzalo Bearman (MCV: VCU Medical Center)H-Index: 24
view all 10 authors...
We employed an interrupted time series analysis to assess the impact of ultraviolet-C light disinfection at terminal discharge in an oncology unit and a bone marrow transplant unit on the incidence of hospital-acquired infections. The deployment of ultraviolet-C light disinfection was associated with a significant decrease in the rate of Clostridioides difficile infections and a significant decrease in the rate of central line–associated blood stream infections in the bone marrow transplant unit...
Source
#1Yilen K. Ng WongH-Index: 2
#2Heba AlhmidiH-Index: 6
Last. Curtis J. Donskey (Case Western Reserve University)H-Index: 49
view all 6 authors...
The frequency of recovery of Clostridium difficile spores from surfaces after postdischarge cleaning of non-C difficile infection rooms was significantly reduced from 24%-5% after a commercial spray formulation of bleach was substituted for a quaternary ammonium disinfectant. These results suggest that routine use of a sporicidal disinfectant in all postdischarge rooms could potentially be beneficial in reducing the risk for C difficile transmission from contaminated surfaces.
2 CitationsSource
Efforts to improve environmental cleaning and disinfection typically focus primarily on high-touch surfaces in patient rooms. This review highlights evidence that portable equipment and other shared devices and floors may be underappreciated as sources of dissemination of health care–associated pathogens. Practical approaches to address these sites of contamination are emphasized.
Source
#1Zeynep TüreH-Index: 3
#2Emine Alp (Erciyes University)H-Index: 26
ABSTRACTInvasive candida infections are the most important causes of nosocomial infections in intensive care units and in risky groups such as immunosuppressed patients. These infections lead to undesirable consequences such as increased morbidity and mortality in patients, prolongation of hospital stay, and increased hospital costs. In recent years, the incidence of non-albicans Candida spp.’s has increased. Unfortunately, some of these species are naturally resistant to first-line antifungals....
1 CitationsSource