262. Microbial Load on Environmental Surfaces: The Relationship Between Reduced Environmental Contamination and Reduction of Healthcare-Associated Infections
Session: Poster Abstract Session: HAI: Environment and Device Cleaning
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • 20161020MicrobialLoad_poster_IDWeek2016.pdf (1007.2 kB)
  • Background: Disinfection of noncritical environmental surfaces and equipment is an essential component of infection prevention as surfaces may contribute to cross-transmission of epidemiologically important pathogens. We monitored four epidemiologically-important pathogens (EIP), including MRSA, VRE, C. difficile and MDR-Acinetobacter. The current study was performed in two hospitals contemporaneously with the BETR-Disinfection study, a multi-center cross-over study comparing the feasibility and effectiveness of three enhanced disinfection strategies for terminal room disinfection against standard practice.

    Methods: Microbiological samples were collected from eight previously-identified high-frequency-touch hospital room surfaces. Each surface was sampled repeatedly using 10 individual Rodac plates (25cm2/plate).

    Results: All enhanced disinfection interventions (i.e., Quat/UV, Bleach, Bleach/UV) were significantly superior to a Quat alone in reducing EIP (Table). The BETR-Disinfection study demonstrated the rate of colonization/infection in a patient subsequently admitted to a room of a patient colonized/infected with an EIP was Quat, 2.3%; Quat/UV, 1.5%; Bleach, 1.9%, and Bleach/UV, 2.2%.

    Conclusion: Comparing the best strategy with the worst strategy (i.e., Quat vs Quat/UV) revealed that a reduction of 94% in EIP (60.8 vs 3.36) led to a 35% decrease in colonization/infection (2.3% vs 1.5%). Our data demonstrated that a decrease in room contamination was associated with a decrease in subsequent patient colonization/infection.

    Table. EIP (mean CFUs/room) by Intervention and Contamination in Patient Rooms

    MDR-Acinetobacter

    C. difficile

    MRSA

    VRE

    EIP

    Intervention

    Room

    Room/BR

    Room

    Room/BR

    Room

    Room/BR

    Room

    Room/BR

    Room

    Room/BR

    Quat

    8.76

    8.95

    0

    3.76

    2.33

    8.52

    8.62

    39.6

    19.71

    60.8

    Quat/UV

    0.18

    0.17

    0.07

    2.86

    0.11

    0.11

    0.07

    0.21

    0.43

    3.36

    Bleach

    0.39

    0.39

    0.04

    4.48

    2.13

    4.39

    0.78

    2.43

    3.35

    11.7

    Bleach/UV

    0.25

    0.25

    0

    3.25

    0.05

    0.85

    0.35

    1.90

    0.65

    6.25

    Quat, quaternary ammonium; BR, bathroom

    Statistical significance (p-value<0.05) was evaluated by the Student’s t-test for all EIP in room alone (room plus bathroom): Quat vs Quat/UV, p=0.0025 (p=0.0128); Quat vs Bleach/UV, p=0.0055 (p=0.0284); Quat vs Bleach, p=0.0132 (p=0.0408).

    William Rutala, PhD, MPH, FSHEA1, Hajime Kanamori, MD, PhD, MPH2, Maria Gergen, MT (ASCP)1, Emily Sickbert-Bennett, PhD, MS2, Lauren Knelson, MSPH3, Luke F. Chen, MBBS, MPH, MBA, CIC, FRACP4, Daniel Sexton, MD4, Deverick Anderson, MD, MPH, FIDSA, FSHEA4 and David J. Weber, MD, MPH, FIDSA, FSHEA5, (1)Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, NC, (2)Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, (3)Duke University Medical Center, Durham, NC, (4)Division of Infectious Diseases, Duke University Medical Center, Durham, NC, (5)Medicine, Pediatrics, Epidemiology, University of North Carolina, School of Public Health, Chapel Hill, NC

    Disclosures:

    W. Rutala, Clorox: Consultant , Scientific Advisor and Speaker's Bureau , Consulting fee , Speaker honorarium and Unrestricted gift for research

    H. Kanamori, None

    M. Gergen, None

    E. Sickbert-Bennett, None

    L. Knelson, None

    L. F. Chen, None

    D. Sexton, None

    D. Anderson, None

    D. J. Weber, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.