Assessing the efficacy of different microfibre cloths at removing surface micro-organisms associated with healthcare-associated infections.

This study investigated the ability of 10 different microfibre cloths to remove microbial contamination from three surfaces commonly found in hospital settings (stainless steel, furniture laminate and ceramic tile), under controlled laboratory conditions. Tests were conducted using organisms known to cause healthcare-associated infections, i.e. meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (in spore form) and Escherichia coli. For all the cloths tested, there was significant statistical evidence to suggest a difference in cleaning performance between them on first and single use (P<0.001). However, the overall performance of the nine re-useable cloths did not differ in practice with differences in log10 reductions of <1. The performance of the disposable microfibre cloth was notably worse. The performance of all cloths decreased with repeated use on a succession of contaminated surfaces. After repeated washing, re-usable cloth performance improved at 75 washes, and reduced after 150 washes, although, in most instances, performance after 150 washes was better than at first wash. For all cloths, price was not an indication of performance. Based on these laboratory findings, it is concluded that use of the microfibre cloths investigated is an effective way to reduce the levels of MRSA, E. coli and C. difficile (in spore form) on a range of surfaces found in the clinical environment and could therefore be of benefit to these environments.

Ward assessment of SmartIdeas Project: bringing source isolation to the patient.

Most UK hospitals lack enough single rooms to provide source isolation for all infected patients. The aim of this study was to test prototype isolation systems on general wards together with specifically designed portable sink units and toilets. Questionnaires were offered to staff, patients and visitors covering ease of use and acceptability. A total of 53 patients were isolated, with concurrent collection of environmental samples and staff hand hygiene audit. Blocking of beds next to infected patients was avoided but patients and staff were concerned about limited space and communication. Hand hygiene compliance on entry or exit to/from an isolated bed space significantly improved [43/76 (56.6%) to 107/147 (72.8%), P<0.05]. Although popular, the toilets were mechanically unreliable. Low levels of microbial contamination (<1-3.4cfu/cm(2)) were present within all isolated bed spaces. The highest colony counts were obtained from high contact sites (e.g. remote controls). Meticillin-resistant Staphylococcus aureus (MRSA) was present at similar levels inside all systems. Although one system was designed to provide airborne as well as contact isolation, MRSA was isolated from air inside and outside the system suggesting poor efficiency of the air door. The finding was confirmed by aerobiology tests at the Health Protection Agency Laboratory, Porton Down, UK. A trial of redesigned units is required to establish efficacy (Trial Identifier: ISRCTN02681602).