Abstract
Aims: High-touch surfaces cleaning and disinfection require the adoption of effective and proper executed protocols, especially during carbapenem-resistant Acinetobacter baumannii (CRAB) endemo-epidemic situations. We evaluated the effectiveness and residual disinfectant activity of disposable pre-impregnated wipes (Modified Operative Protocol, MOP) in reducing environmental bioburden versus a two-step Standard Operative Protocol (SOP) in a 12-bed Intensive Care Unit. Methods: Five high-touch surfaces were cleaned and disinfected either according to the SOP (alcohol-based cleaning and chlorine-based disinfection) or using quaternary ammonium compounds-based disposable wipes (MOP). Sampling was performed before each procedure and at 0.5, 2.5, 4.5 and 6.5 h after (560 sites). Total viable count (TVC) was evaluated according to Italian hygiene standard (<50 CFU/24 cm2). Clinical and environmental CRAB strains isolated were genotyped. Results: On non-electromedical surfaces the difference between TVC before procedure and at each of the following times was significant only for the MOP (p < 0.05, Wilcoxon test). Using the MOP, only 7.4% (10/135) of sites showed TVC >50 CFU/24 cm2 (hygiene failures) versus 18.9% (25/132) after SOP (p < 0.05, Fisher’s Exact test). On infusion pumps a higher number of hygiene failures was observed after the SOP (7/44, 15.9%) compared with the MOP (4/45, 8.9%). Genotyping highlighted a common source of infection. Conclusion: On high-touch surfaces, the use of disposable wipes by in-house auxiliary nurses may represent a more effective alternative to standard cleaning and disinfection procedure performed by outsourced cleaning services, showing effectiveness in reducing microbial contamination and residual disinfection activity up to 6.5 h.
Highlights
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], they are recommended to be cleaned and disinfected on a more frequent schedule than minimal touch surfaces [5]
After 0.5 h from the cleaning and disinfection (C&D), the initial average Total viable count (TVC) detected on all non-electromedical high-touch
After 0.5 h from the C6D, the initial average TVC detected on all non-electromedical high-touch surfaces was reduced from 34 CFU/24 cm2
Summary
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], they are recommended to be cleaned and disinfected on a more frequent schedule than minimal touch surfaces [5]. The ready-to-use wipes are increasingly used in health care settings, different antimicrobial wipes have shown a variable effectiveness in removing microbial bioburden from inanimate surfaces and in reducing the pathogens transfer between surfaces [11]. As reported by Sattar et al [12], the use of wipes containing 0.5% accelerated H2 O2 or sodium hypochlorite solution
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