Microbial Assessment of Recontamination with Acinetobacter in Patient Room Environment in Burn Units

Abstract

<h3>Background</h3> Acinetobacter is an important opportunistic pathogen causing healthcare-associated infections and outbreaks in burn patients. The healthcare environment can be persistently contaminated despite routine room cleaning/disinfection and recontaminated via healthcare personnel and patients. The aim of this study was to investigate the microbial burden on patient room environment in burn units and assess how much environmental sites become recontaminated with Acinetobacter over time after cleaning/disinfection. <h3>Methods</h3> This study was conducted in burn units of an academic hospital. A baseline of the amount of contamination were evaluated by sampling six environmental sites (i.e., chair, bed rail, overbed table, supply cart, stock cabinet, IV pump, and monitor) with Rodac plates in four rooms housing patients with Acinetobacter infection/colonization. After cleaning/disinfection, samples were taken from those sites at 1-hour intervals for ten hours. Two Rodac plates were collected at each site, and total colony forming units (CFU) and Acinetobacter counts were calculated. <h3>Results</h3> Mean aerobes and Acinetobacter CFU/RODAC in four rooms housing patients with Acinetobacter were determined. At baseline all environmental sites sampled except overbed table were contaminated with Acinetobacter. Immediately after cleaning/disinfection, Acinetobacter was only detected on the bed rail (1 CFU). First time to recontamination with Acinetobacter was as follows: chair, 3 hours; overbed table, 2 hours; stock cabinet, 3 hours; and IV pump, 2 hours. No recontamination were observed at the monitor. The level of Acinetobacter contamination on surfaces was occasionally high (e.g., when stock cabinet sampled at 5 hours, 75 of 96 CFU were Acinetobacter). The amount of recontamination with aerobes and Acinetobacter increased over time. <h3>Conclusions</h3> Our study demonstrated that recontamination with Acinetobacter occurred rapidly at environmental sites in burn units even after cleaning/disinfection and underscored the need for enhanced environmental cleaning, including continuous disinfection methods, to prevent transmission of healthcare-associated pathogens.