Abstract
Implementation of environmental cleaning and disinfection has been shown to reduce the incidences of healthcare-associated infections. The effect of an enhanced strategy for terminal room disinfection, applying the pulsed xenon-based ultraviolet light no-touch disinfection systems (PX-UVC) after the current standard operating protocol (SOP) was evaluated. In a teaching hospital, the effectiveness in reducing the total bacterial count (TBC) and in eliminating high-concern microorganisms was assessed on five high-touch surfaces in different critical areas, immediately pre- and post-cleaning and disinfection procedures (345 sampling sites). PX-UVC showed only 18% (15/85) of positive samples after treatment compared to 63% (72/115) after SOP. The effectiveness of PX-UVC was also observed in the absence of manual cleaning and application of a chemical disinfectant. According to the hygienic standards proposed by the Italian Workers Compensation Authority, 9 of 80 (11%) surfaces in operating rooms showed TBC ≥15 CFU/24 cm2 after the SOP, while all samples were compliant applying the SOP plus PX-UVC disinfection. Clostridium difficile (CD) spores and Klebsiella pneumoniae (KPC) were isolated only after the SOP. The implementation of the standard cleaning and disinfection procedure with the integration of the PX-UVC treatment had effective results in both the reduction of hygiene failures and in control environmental contamination by high-concern microorganisms.
Highlights
The role of healthcare workers (HCW) in the transmission of pathogens from patient-to-patient is well documented; increasing evidence reports the contaminated environment as highly significant in pathogen transmission; in particular, high-touch surfaces are recognized as a possible reservoir of infectious agents and their contamination can pose a risk for the spread of multi-resistant organisms [1,2,3,4]
All but 39 were consistent with skin commensal (106 were Staphylococcus spp.) and of these, 6 colonies of mold were grown, Gram negative bacteria (three Enterobacter cloacae, one Vibrio alginoliticus, 10 Cryseobacterium menigosepticum, seven Edwarsiella hoshinae, two Methylobacterium mesofilicum, four KPC-K. pneumoniae, two Extended Spectrum β Lactamase-producing Klebsiella pneumoniae (ESBL-K. pneumoniae)) and four bacillus identified as C. difficile
The average of CFUs was 6 ± 10 standard deviation (SD) CFU/24 cm2 in operating theatres (OT) with low turnover, 7 ± 12 SD CFU/24 cm2 in OTs with high turnover, 25 ± 19 SD CFU/24 cm2 in the Intensive Care Units (ICU), and 58 ± 54 SD CFU/24 cm2 in patient rooms at discharge.After standard operating protocol (SOP), the average of CFUs increased to 11 ± 18 SD CFU/24 cm2 in OTs with low turnover (+83%), while it decreased to 1 ± 1 SD CFU/24 cm2 (−7%) in OTs with high turnover, and in
Summary
The role of healthcare workers (HCW) in the transmission of pathogens from patient-to-patient is well documented; increasing evidence reports the contaminated environment as highly significant in pathogen transmission; in particular, high-touch surfaces are recognized as a possible reservoir of infectious agents and their contamination can pose a risk for the spread of multi-resistant organisms [1,2,3,4]. Public Health 2019, 16, 3572; doi:10.3390/ijerph16193572 www.mdpi.com/journal/ijerph
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