Sequential enhanced cleaning eliminates multidrug-resistant organisms in general intensive care unit of a traditional Chinese medicine hospital.

PURPOSE: Effective cleaning of surfaces within hospital wards is necessary to reduce pathogen transmission. We investigated the roles of sequential enhanced cleaning by culturing pathogens from high-touch surfaces in a general intensive care unit. METHODS: A before-after controlled study was conducted during a 17-month period in the 25-bed general intensive care unit. The study comprised a baseline period (period 1) and 4 sequential tiered interventions: each patient zone was wiped with a single clean microfiber cloth daily (period 2), fluorescent markers and adenosine triphosphate assay were used to monitor and provide feedback on the effectiveness of cleaning (period 3), wiping a single patient zone with 3 clean microfiber cloths daily (period 4), and withdrawal of the feedback (period 5). RESULTS: Compared with period 1, the cultures of multidrug-resistant organisms from high-touch surfaces were reduced by 41.0% (prevalence ratio [OR] = 0.59, P < .001), 70.8% (OR = 0.29, P < .001), 82.6% (OR = 0.17, P < .001), and 70.8% (OR = 0.29, P < .0001) in the subsequent sequential interventions, respectively. CONCLUSION: Adoption of fluorescent markers and adenosine triphosphate bioluminescence reduced environmental contamination. Use of 3 cleaning cloths for 1 patient zone was more effective compared with a single cloth.

Impact of relocation and environmental cleaning on reducing the incidence of healthcare-associated infection in NICU.

BACKGROUND: Hospital environment remains a risk for healthcare-associated infections (HAIs). This was a prospective study to evaluate the comprehensive impact of relocating a neonatal intensive care unit (NICU) to a new facility and improved environmental cleaning practice on the presence of methicillin-resistant Staphylococcus aureus (MRSA) on inanimate surfaces and the incident rate of HAIs. METHODS: New environmental cleaning measures were adopted after the NICU was moved to a new and better-designed location. The effect of moving and the new environmental cleaning practice was investigated by comparing the positive number of MRSA on ward surfaces and the incidence density of HAIs between the baseline and intervention periods. RESULTS: Only 2.5% of environmental surfaces were positive for MRSA in the intervention period compared to 44.0% in the baseline period (P<0.001). Likewise, the total incident rate of HAIs declined from 16.8 per 1000 cot-days to 10.0 per 1000 cot-days (P<0.001). CONCLUSION: The comprehensive measures of relocating the NICU to a new facility design with improved environmental cleaning practice are effective and significantly reduce the incidence of HAIs.

A randomized, double-blind comparison of the effectiveness of environmental cleaning between infection control professionals and environmental service workers.

The hospital environment is a reservoir for pathogens, and environmental service workers (ESWs) play an important role in infection prevention. A randomized, double-blind comparison was carried out in a 23-bed intensive care unit of a traditional Chinese medical-Western medical hospital. Aerobic colony counts (ACC) and methicillin-resistant Staphylococcus aureus (MRSA) were used to compare the effectiveness of environmental cleaning between infection control professionals and ESWs. The results suggest that high-touch surfaces around MRSA patients are often not sufficiently cleaned and are even cross-contaminated by ESWs after cleaning. Further educational intervention is needed for improvement of environmental cleaning.