Hospital Environmental Surfaces Research Articles

Lowering the Acquisition of Multi-drug Resistant Organism (MDROs) with Pulsed-xenon (LAMP) Study: a cluster randomized controlled, double-blinded, interventional crossover trial.

Environmental disinfection is essential for reducing spread of healthcare associated infections (HAIs). Previous studies report conflicting results regarding the effects of ultraviolet light (UV) in reducing infections. This trial evaluated the impact of adding pulsed xenon UV (PX-UV) to standard terminal cleaning in reducing environmentally-implicated HAIs (eiHAIs). The LAMP trial was conducted in 2 hospitals (15 inpatient wards) utilizing a cluster randomized controlled, double-blinded, interventional crossover trial comparing standard terminal cleaning followed by either pulsed xenon ultraviolet (PX-UV) disinfection (intervention arm) or sham disinfection (control arm). The primary outcome was incidence of eiHAIs from clinical microbiology tests on the 4th day of stay or later or within 3 days after discharge from the study unit. EiHAIs included clinical cultures positive for vancomycin-resistant enterococci (VRE), extended spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumonia, methicillin-resistant Staphylococcus aureus (MRSA), and Acinetobacter baumannii, and stool PCR positive for Clostridiodes difficile. Between May 18, 2017 to Jan 7, 2020, 25,732 patients were included, with an incidence of 601 eiHAI and 180,954 patient days. There was no difference in the rate of eiHAIs in the intervention and sham arms (3.49 vs 3.17 infections/1000 patient days respectively, RR 1.10 CI (0.94, 1.29, p= 0.23)). Study results were similar when stratified by eiHAI type, hospital, and unit type. The LAMP study failed to demonstrate an effect of the addition of UV light disinfection following terminal cleaning on reductions in rates of eiHAIs. Further investigations targeting hospital environmental surfaces and the role of no touch technology to reduce HAIs are needed.

Insights into the Microbiome and Antibiotic Resistance Genes from Hospital Environmental Surfaces: A Prime Source of Antimicrobial Resistance.

Hospital environmental surfaces are potential reservoirs for transmitting hospital-associated pathogens. This study aimed to profile microbiomes and antibiotic resistance genes (ARGs) from hospital environmental surfaces using 16S rRNA amplicon and metagenomic sequencing at a tertiary teaching hospital in Malaysia. Samples were collected from patient sinks and healthcare staff counters at surgery and orthopaedic wards. The samples' DNA were subjected to 16S rRNA amplicon and shotgun sequencing to identify bacterial taxonomic profiles, antibiotic resistance genes, and virulence factor pathways. The bacterial richness was more diverse in the samples collected from patient sinks than those collected from staff counters. Proteobacteria and Verrucomicrobia dominated at the phylum level, while Bacillus, Staphylococcus, Pseudomonas, and Acinetobacter dominated at the genus level. Staphylococcus epidermidis and Staphylococcus aureus were prevalent on sinks while Bacillus cereus dominated the counter samples. The highest counts of ARGs to beta-lactam were detected, followed by ARGs against fosfomycin and cephalosporin. We report the detection of mcr-10.1 that confers resistance to colistin at a hospital setting in Malaysia. The virulence gene pathways that aid in antibiotic resistance gene transfer between bacteria were identified. Environmental surfaces serve as potential reservoirs for nosocomial infections and require mitigation strategies to control the spread of antibiotic resistance bacteria.

Biofilms on medical instruments and surfaces: Do they interfere with instrument reprocessing and surface disinfection

Biofilms are surface-attached communities of bacteria embedded in an extracellular matrix. This matrix shields the resident cells from desiccation, chemical perturbation, invasion by other bacteria, and confers reduced susceptibility to antibiotics and disinfectants. There is growing evidence that biofilms on medical instruments (especially endoscopes) and environmental surfaces interfere with cleaning and disinfection. The English literature on the impact of biofilms in medicine was reviewed with a focus on the impact of biofilms on reusable semicritical medical instruments and hospital environmental surfaces. Biofilms are frequently present on hospital environmental surfaces and reusable medical equipment. Important health care...associated pathogens that readily form biofilms on environmental surfaces include Staphylococcus aureus, Pseudomonas aeruginosa, and Candida auris. Evidence has demonstrated that biofilms interfere with cleaning and disinfection. New technologies such as ..úself-disinfecting..Ñ surfaces or continuous room disinfection systems may reduce or disrupt biofilm formation and are under study to reduce the impact of the contaminated surface environment on health care...associated infections. Future research is urgently needed to develop methods to reduce or eliminate biofilms from forming on implantable medical devices, reusable medical equipment, and hospital surfaces.

SG-APSIC1089: Environmental screening of SARS CoV-2 to support an outbreak investigation in Sardjito Hospital, Yogyakarta, Indonesia

Objectives: Many healthcare workers and patients in intensive care units of Sardjito Hospital, a referral and academic hospital in Yogyakarta, Indonesia, were infected with SARS-CoV-2 in June–August 2021, during the second wave of the COVID-19 pandemic. Much evidence has shown that SARS-CoV-2 persists on hospital environmental surfaces and medical equipment. We investigated the potential sources of virus in our cases, particularly environmental contamination. Methods: Environmental screening for SARS-CoV-2 was conducted using RT-PCR of swabs collected from case-related medical equipment and hospital surfaces. We examined the environmental cleaning method in these areas as well. Results: We swabbed medical equipment in close contact with patient droplets such as the ventilator, the high-flow nasal cannula, the nebulizer, and suction equipment, as well as some environmental surfaces near the patient, such as the bed rail, air conditioning unit, and portable HEPA-filter outlet. Among 19 samples, genetic material of SARS-CoV-2 was detected only on a sample from a nebulizer. The point of contamination was on the outer body of that nebulizer, which indicated that the contact transmission source might be from patient droplets and/or inadequate cleaning. No more positive results emerged from our screening, indicating that the environmental cleaning was adequate. The IPC team recommended that we no longer use nebulizers for COVID-19 patients and that the cleaning procedure be improved, particularly after the device is used. Conclusions: Environmental screening for SARS-CoV-2 can be used to support investigations of inpatient COVID-19 outbreaks in hospitals. Adequate cleaning and care procedures for medical equipment are very important in preventing the transmission of SARS-CoV-2 in the hospital setting.

Role of hospital environmental surfaces in the transmission of the severe acute respiratory syndrome - Coronavirus-2.

Severe acute respiratory syndrome - Coronavirus-2 (SARS-CoV-2) is mainly transmitted via respiratory secretions through coughing, sneezing, or contact with contaminated surfaces. This virus can be present in feces and many body fluids. The study aimed to screen the hospital environment as a potential source for SARS-CoV-2 transmission and identify the hospital zones with the highest contamination levels. Swabs were collected from different sites in the hospital before and after routine cleaning/disinfection, transported in vials containing 1-3 mL of viral transport medium, and stored at -80 ℃ as soon as possible until the time of testing. The real-time reverse-transcription PCR (rRT-PCR) system targeting RNA-dependent RNA polymerase and E genes was used to detect the SARS-CoV-2 RNA. Moderate environmental contamination by SARS-CoV-2 RNA was detected by rRT-PCR before routine cleaning/disinfection (52% of the swabs were positive). The hospital surfaces with the highest contamination levels were elevators' buttons, sinks and faucets' handles at the waiting rooms, patient's room and bathroom, call buttons and telephones in the patient's room, toilet bowl surface, the doorknob and light switches at the X-ray room, and the computer keyboard at the staffroom. All the swabs collected after routine cleaning/disinfection were negative for SARS-CoV-2 RNA by rRT-PCR. The hospital environment is a high-risk area that can be contaminated by SARS-CoV-2 through contact, respiratory, and maybe fecal shedding of the virus. To limit this fatal virus transmission, strict adherence to proper hand hygiene with frequent optimal decontamination of hospital environmental surfaces is essential.

Identifying and elucidating the resistance of Staphylococcus aureus isolated from hospital environment to conventional disinfectants

BackgroundStaphylococcus aureus is a nosocomial pathogen, detection and elucidation of its resistance mechanisms to conventional disinfectants may aid in limiting its spread on environmental surfaces in health care settings. In the current study, disinfectant susceptibility of S. aureus strains isolated from the hospital environment as well as possible associations between the presence of disinfectant-resistance genes and reduced susceptibility to disinfectants was investigated. MethodsA total of 245 samples were collected from the hospital environmental surfaces. The minimum inhibitory (MIC) and bactericidal concentrations (MBC) of disinfectants against S. aureus isolates were determined using the micro-broth dilution method. The qac genes (qacA, qacE, and qacΔE1) were detected by PCR and confirmed by sanger sequencing. ResultsA total of 47 S. aureus strains were isolated, with more than 85% of them showing methicillin resistance. The qacA, qacE, and qac∆E1 genes were found in 23.4%, 29.7%, and 4.2% isolates respectively. All the isolates with qac genes had higher MIC and MBC values to selected disinfectants. ConclusionsSignificant methicillin resistant S. aureus (MRSA) contamination in the hospital environment was detected. Furthermore, higher qac gene frequencies were found in MRSA isolates that also correlated with higher MIC/MBC values to different disinfectants. The study proposes that hospitals should develop policies to determine disinfectant MICs against the common environmental isolates to contain the spread of resistant strains.

Metagenomic Sequencing and Reverse Transcriptase PCR Reveal That Mobile Phones and Environmental Surfaces Are Reservoirs of Multidrug-Resistant Superbugs and SARS-CoV-2.

BackgroundMobile phones of healthcare workers (HCWs) can act as fomites in the dissemination of microbes. This study was carried out to investigate microbial contamination of mobile phones of HCWs and environmental samples from the hospital unit using a combination of phenotypic and molecular methods.MethodsThis point prevalence survey was carried out at the Emergency unit of a tertiary care facility. The emergency unit has two zones, a general zone for non-COVID-19 patients and a dedicated COVID-19 zone for confirmed or suspected COVID-19 patients. Swabs were obtained from the mobile phones of HCWs in both zones for bacterial culture and shotgun metagenomic analysis. Metagenomic sequencing of pooled environmental swabs was conducted. RT-PCR for SARS-CoV-2 detection was carried out.ResultsBacteria contamination on culture was detected from 33 (94.2%) mobile phones with a preponderance of Staphylococcus epidermidis (n/N = 18/35), Staphylococcus hominis (n/N = 13/35), and Staphylococcus haemolyticus (n/N = 7/35). Two methicillin-sensitive and three methicillin-resistant Staphylococcus aureus, and one pan-drug-resistant carbapenemase producer Acinetobacter baumannii were detected. Shotgun metagenomic analysis showed high signature of Pseudomonas aeruginosa in mobile phone and environmental samples with preponderance of P. aeruginosa bacteriophages. Malassezia and Aspergillus spp. were the predominant fungi detected. Fourteen mobile phones and one environmental sample harbored protists. P. aeruginosa antimicrobial resistance genes mostly encoding for efflux pump systems were detected. The P. aeruginosa virulent factor genes detected were related to motility, adherence, aggregation, and biofilms. One mobile phone from the COVID-19 zone (n/N = 1/5; 20%) had positive SARS-CoV-2 detection while all other phone and environmental samples were negative.ConclusionThe findings demonstrate that mobile phones of HCWs are fomites for potentially pathogenic and highly drug-resistant microbes. The presence of these microbes on the mobile phones and hospital environmental surfaces is a concern as it poses a risk of pathogen transfer to patients and dissemination into the community.

Microbial burden on environmental surfaces in patient rooms before daily cleaning-Analysis of multiple confounding variables.

Estimated levels of microbial burden on hospital environmental surfaces vary substantially among published studies. Cultures obtained during a cluster-controlled crossover trial of a quaternary ammonium (Quat) disinfectant versus an improved hydrogen peroxide (IHP) disinfectant provided additional data on the amount of microbial burden on selected surfaces. RODAC plates containing D/E neutralizing agar were used to sample a convenience sample of 5-8 high-touch surfaces in patient rooms on 2 medical wards, an intensive care unit, and a step-down unit at a large hospital. Before routine daily cleaning, samples were obtained in varying rooms over an 11-month period. RODAC plates (1 per surface sampled) were incubated for 72 hours, and aerobic colony counts per plate (ACCs) were determined. Statistical analysis was used to determine the potential impact on ACCs of study period, cleaning compliance rate, disinfectant used, ward, surface sampled, and isolation room status. Overall, 590 cultures were obtained on Quat wards and 589 on IHP wards. Multivariable regression analysis revealed that mean ACCs differed significantly by site (P < .001), type of ward (P < .001), isolation room status (P = .039), and study period (P = .036). The highest mean ACCs per RODAC plate were on toilet seats (112.8), bedside rails (92.0), and bathroom grab bars (79.5). The combination of factors analyzed revealed that estimating microbial burden is complex and is affected by multiple factors. Additional studies should evaluate individual sites, ward types, cleaning and disinfection practices, and isolation room status.

Bacterial Contaminants on Exposed Surfaces and Their Antibiotic Sensitivity Patterns at the Benjamin Mkapa Hospital, Dodoma-Tanzania

Background: Hospital acquired infection pose a great challenge in provision of healthcare services to many settings particulary in developing countries where there is limited availability of resources. The roles played by exposed surfaces in spreading of potential bacterial pathogens within the hospital environment have certainly contributed to the increased burden of bacterial infectious diseases such as morbidness, death as well as cost imolecation in healthcare. Our study aimed to determine common bacteria isolated on exposed surfaces and the antimicrobial sensitivity patterns.&#x0D; Methods: A sum of 516 specimens gathered and enrolled for study at Benjamin Mkapa Hopsital (BMH). The swab specimens were continuously gathered (collected) from different exposed objects in hospital environmental surfaces. All microbiological procedures or tests were performed using appropriate standard operating procedure. The obtained data were analysed using SPSS version 16.0.&#x0D; Results: Among 516 samples, 317 (61.4%) were positive with variety of bacterial isolates from different sites. Out of 317 positive cultures, 120 (37.9%) Staphylococcus aureus, 97 (30.6%) E. coli, 28 (8.8%) Enterobacter aerogenes, 25 (7.9%) Pseudomonas aeruginosa, 23 (7.3%) other Citrobacter species, 20 (6.3%) Citrobacter freundii, 3 (0.9%) Morganella morganii and 1 (0.3%) Serratia mercesens were isolated from different source of exposed surfaces at BMH. Serratia mercesens were highly (100%) resistant to most of the antimicrobial agents including erythromycin, cefotaxime, ciprofloxacin, gentamicin, amikacin, penicillin,ceftriaxone, ceftazidime, levofloxacin, ampicillin, azithromycin and cotrimoxazoleTrimethoprim/sulfamethoxazole.&#x0D; Conclusion: High levels of potentially pathogenic bacteria were isolated in swab specimens from a wide range of exposed surfaces at BMH. Variable pattern of antiobiotic resistance were observed among bacterial isolates with alarming levels demonstrated by isolates of Serratia mercesens which is amongst the common causes of surgical site infections. This findings call for improved actions for infection prevention and control measures at BMH.

Antimicrobial resistance: considerations on present and future strategies

Abstract Antimicrobial resistance (AMR) is a global emergency that requires the use of short and long-term strategies. The existence of this phenomenon had been hypothesized by the discoverer of penicillin already in the first years in which this antibiotic drug began to be used, however the historical analysis on the onset and growth of the problem, together with an epistemological approach concerning its possible overcoming, suggest that research and production of new antibiotics cannot be its definitive solution. This may represent the main short-term strategy, to be pursued also thanks to economic incentives in favor of the pharmaceutical industries and privileged institutional pathways in the health sector, but future strategies to combat AMR must be based on an evolutionary vision of biomedicine. Approaches based on the evolutionary mechanisms of natural selection, the fight for existence and biological competition to occupy specific niches, represent the integrative methods of the present and above all the innovative ones of the future. The use of available vaccinations to combat specific bacterial and viral infections, the production of vaccines directed against resistant bacteria, therapies that use specific viruses capable of infecting and killing bacteria (phage therapies), non-chemical but biological sanitation systems of the surfaces in hospital environment (microbiological cleaning), biological therapies with the administration of populations of non-pathogenic bacteria capable of contrasting and eliminating pathogenic bacteria (microbiological therapy), microbiome transplants to transform the microbiological population of man in a means therapeutically useful against resistant bacteria (macrobiome transplant), are the strategies against AMR that will be discussed in this paper. Key messages Promote the production of new antibiotics in the present to win AMR. Evolutionary medicine is the key for futures strategies against AMR.

SARS-CoV-2 RNA detection of hospital isolation wards hygiene monitoring during the Coronavirus Disease 2019 outbreak in a Chinese hospital

ObjectivesThe aim of this paper was to monitor the presence of SARS-Cov-2 among hospital environment surfaces, sewage, and personal protective equipment (PPE) of staffs in isolation wards in the First Affiliated Hospital of Zhejiang University, China. MethodsSurfaces of objects were routinely wiped with 1000mg/L chlorine containing disinfectant. Air and sewage disinfection was proceeded routinely and strictly. Hospital environmental surfaces and PPE of staffs in isolation wards were sampled using swabs. The sewage from various inlet and outlets were sampled. The respiratory and stool specimens of patients were collected. The respiratory specimens of staffs in the isolation wards were also sampled once a week. Quantitative real-time reverse transcription PCR (qRT-PCR) methods were used to confirm the existence of SARS-Cov-2 RNA. Viral culture was done for the samples positive for SARS-Cov-2 RNA. ResultsDuring the study period, 33 laboratory-confirmed patients were hospitalized in isolation wards in the hospital. None of SARS-Cov-2 RNA was detected among the 36 objects surface samples and 9 staffs PPE samples in isolation wards. Though the 3 sewage samples from the inlet of preprocessing disinfection pool were positive for SARS-CoV-2 RNA and the sample from the outlet of preprocessing disinfection pool was weakly positive, the sewage sample from the outlet of the last disinfection pool was negative. All of the 5 sewage samples from various points were negative by viral culture of SARS-Cov-2. None of the respiratory specimens of staffs in the isolation wards were positive. ConclusionsThough SARS-Cov-2 RNA of the sewage samples were positive from inlets of the sewage disinfection pool and negative from the outlet of the last sewage disinfection pool, no viable virus was detected by culture. The monitoring data in this study suggested that the strict disinfection and hand hygiene could decrease the hospital-associated COVID-19 infection risk of the staffs in isolation wards.

2410. Molecular Characteristics of Environmental Clostridioides difficile From a Large Texas Hospital

Background Clostridioides difficile is an anaerobic spore-forming, toxin-producing Gram-positive bacillus listed by the CDC as an “urgent threat” pathogen. Epidemiologic studies using whole-genome sequencing (WGS) have found that genetically distinct lineages infections occur in hospitalized patients, in addition to the fact that C. difficile spores persist on hospital surfaces after disinfection. The purposes of this study were to isolate and characterize C. difficile from the environment of a large Texas hospital.MethodsWe collected 330 swab samples of hospital environmental surfaces using sterile cotton gauze. The samples were then anaerobically enriched in brain heart infusion broth for 48–72 hours and plated onto cycloserine–cefoxitin fructose agar (CCFA). Suspected colonies were then genetically characterized using PCR (for tcdA, tcdB, cdtA, cdtB and tpi genes) and genotyped using fluorescent PCR ribotyping techniques.ResultsA total of 90/330 (27.3%) environmental samples were culture positive for C. difficile, of which 75/90 (82.1%) tested were toxigenic C. difficile by the presence of tcdA, tcdB, cdtA or cdtB. A total of 16 distinct ribotypes were identified from 41 C. difficile isolates tested using a fluorescent-ribotyping method. The predominant ribotypes isolated were F078–126 (8/41), F002 (5/41), F106 (4/41), F255 (4/41), and F014-020 (3/41).ConclusionWe found a diversity of C. difficile strain types in various hospital high-touch surface environment in addition to ribotype F027 and F078, suggesting the hospital environment a reservoir and significant source C. difficile infections.Disclosures All authors: No reported disclosures.

Cleaning and disinfecting protocols for hospital environmental surfaces: A systematic review of the literature

Background: Healthcare associated infections are a leading cause of illness and death in the United States and across the world. Environmental surfaces are considered non-critical, although recent evidence suggests that the built environment may contribute to the transmission of pathogens. Ineffective cleaning and disinfecting of environmental non-critical surfaces may increase risk of transmitting nosocomial pathogens leading to hospital acquired infections among hospital patients.Objective: This systematic review identifies elements of cleaning and disinfecting protocols, synthesizing the evidence to evaluate cleaning protocols that effectively reduce surface contamination and minimize risk of hospital acquired illness.Methods: A systematic literature review was conducted with a clearly formulated research question and systematic approach to identify publications, select relevant studies, critically appraise the research through analysis of reported data, and reported the results according to the Cochrane methodology.Results: In total, 245 studies were initially identified with 19 studies meeting inclusion criteria. Emerging categories include chemical application methods, chemical application time, cleaning type and frequency, and interventions for training and monitoring.Conclusions: Establishing adequate cleaning protocols for hospital environments is a complex process which requires consideration of multiple components including mechanical action, chemical application materials, types of cleaning, chemical contact times, education and training of EVS staff, cleaning monitoring and feedback, no-contact cleaning methods, and self-disinfecting surfaces. Recommendations for protocol development based on the study results are provided.

Could Training Programs Eliminate Hospital Environmental Surfaces Contamination with Multidrug Resistant Bacteria

Could Training Programs Eliminate Hospital Environmental Surfaces Contamination with Multidrug Resistant Bacteria

Microorganisms Isolated from Hospital Environmental Surfaces in Akure Metropolis, Ondo State, Nigeria

Nosocomial infection is a rising problem in developing countries. Microorganisms Isolated from three private and public hospital environmental surfaces in Akure Metropolis, Ondo State, Nigeria were investigated in this study. Bacterial and fungal organisms were isolated and compared among the three hospitals. The study revealed that bacteria were the most predominant microorganisms found in the hospital environmental surfaces than fungi. Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Bacillus cereus were the bacterial isolates while fungi include Aspergillus fumigatus, Aspergillus niger and Candida albicans. Staphylococcus aureus was found to be predominant bacteria but Aspergillus funmigatus was the predominant fungi. The result showed that the microbial loads of the public hospitals were higher than that of the private hospitals. The bacteria load of the male ward was found to be higher than that of the female ward while the fungal loads of each of the hospital environmental surfaces of female were higher than that of the male. The study revealed that bacteria were the most predominant microorganisms found in the hospital environment than fungi. Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Bacillus cereus were the bacterial isolates while fungi include Aspergillus fumigatus, Aspergillus niger and Candida albicans. Staphylococcus aureus was found to be predominant bacteria. All the hospital environmental surfaces were contaminated with one or more microorganisms in the course of the research.

Environmental services impact on healthcare–associated Clostridium difficile reduction

BackgroundHealthcare–associated Clostridium difficile infection (CDI) can result from organisms found on hospital environmental surfaces. Without proper cleaning of hospital environmental surfaces, cross-contamination can occur, resulting in a healthcare–associated infection. In 2011, an environmental services (EVS) model was developed in Hospital A that resulted in a reduction in healthcare–associated CDI. The purpose of this study was to determine if implementing Hospital A's EVS model in Hospital B would decrease healthcare–associated CDI incidence. MethodsA quasi-experimental design was used. The study was conducted in Hospital B, a 53-bed acute care community-based hospital, between January 2013 and December 2017. A retrospective review of all CDI LabID A/B toxin enzyme immunoassay events was performed using the National Healthcare Safety Network surveillance definitions. The data were calculated based on incidence rates per 1,000 patient days and the National Healthcare Safety Network standard infection ratio formula. No new disinfectants, antibiotic restrictions, or new isolation techniques were instituted during this time period. ResultsThere was a 100% reduction in healthcare–associated CDI in Hospital B from 2013’s baseline rate of 0.48 per 1,000 patient days to 0.00 per 1,000 patient days (0.48, 0.00, P = 0.020). ConclusionsThis study highlights the importance of EVS education and accountability as well as recognition of the role played by EVS in reducing healthcare–associated CDI within healthcare facilities.

2181. Efficacy of UV-C Disinfection with or Without Sodium Hypochlorite Compared with Usual Disinfection of Hospital Environmental Surfaces: Pilot Study

BackgroundThe hospital environment is known to harbor pathogens that cause healthcare-associated infections. Sodium hypochlorite (NaClO) has been a common method for disinfection due to its low cost and wide availability. Nevertheless, UV-C is less time-consuming and less prone to human errors. We are aware of only one study that has directly compared UV-C against NaClO in a high-income country.1MethodsA pilot study was designed to test three different methods for terminal room disinfection: (1) NaClO (1,000 ppm); (2) UV-C (two 5-minute cycles at a maximum radius of 2.4 m with the UVDI UV360™ device); and (3) NaClO followed by UV-C. After patient discharge, housekeeping staff cleaned every room with detergent. Next, the rooms were subjected to one of the three disinfection procedures in a nonrandomized way. Environmental cultures were taken before and after cleaning and after every disinfection procedure, from three high touch areas: bedrails, patient tables and mattresses. Bedrails were sampled with swabs and the rest of the surfaces with RODAC™ plates. Cultures were processed by the same external accredited laboratory. Our main objective was to calculate reductions in total bacterial counts (measured in CFUs) to estimate the sample size for a larger multicenter study. We hypothesized that similar bacterial count reductions would be observed for the three methods.ResultsEight rooms were tested in 4 hospitals in Mexico City (total of 85 cultures). Median bacterial count reductions with their respective IQRs, adjusted to CFUs after cleaning, were: 1 (0–10) after NaClO only; 5 (0–30) after UV-C only, and 1 (0–10) after NaClO + UV-C (Kruskal–Wallis test, P = 0.419); the respective median proportion reductions were 95.8% (0–100%), 90.1% (75–100%) and 100% (10–100%).ConclusionAll three disinfection methods seem to be equally effective for the reduction of total bacterial counts on hospital surfaces, regardless the type of hospital or ward. With a sufficiently powered study, we will attempt to demonstrate that UV-C alone could be used instead of NaClO (reference disinfectant in Mexico), possibly with time and economic savings.Disclosures All authors: No reported disclosures.

Antibiotic Susceptibility Profile of Bacteria Isolated from Door Handles of University of Benin Teaching Hospital, Benin City, Edo State, Nigeria

In recent times, surfaces of hospital environment, constantly exposed to activities of patients and health-care workers, have been identified as potential routes for horizontal dissemination of drug resistant microorganisms of public health significance. This study was conducted to investigate the antibiotic resistance profile of bacteria isolated from samples collected from door handles of various units in University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria. Out of the 66 door handles sampled and analysed bacteriologically, 68 predominant bacteria distributed among five (5) species of Escherichia coli (30.9%), Staphylococcusaureus (26.5%), Pseudomonas aeruginosa (17.6%), Streptococcus pneumonia (13.2%) and Bacillus subtilis (11.8%) were isolated. Kirby Bauer techniques of disk diffusion antibiotic susceptibility test on the isolates using 9 commercial antibiotics according to Clinical Laboratory Standards Institute (CLSI) procedure showed resistance of P. aeruginosa to five (5) drugs (Sulfamethoxazole-Trimethoprim, Streptomycin, Ampicillin, Cephalexin and Nalidixic acid), E. coli to five (5) drugs (Ofloxacin, Sulfamethoxazole-Trimethoprim, Ampicillin, Cephalexin and Nalidixic acid), S. pneumoniaeto two drugs (Ampicilin and Nalidixic acid) and S aureus to only Nalidixic acid. Agarose gel electrophoresis carried out on their plasmid DNA revealed detectable fragments in P. aeruginosa and E. coli. After plasmid curing, the isolates became sensitive to Streptomycin, Cephalexin,Ofloxacin, Sulfamethoxazole-Trimethoprim, Ampicillin and Ciprofloxacin. Findings from this study suggest the presence of plasmid mediated multi-drug resistant P. aeruginosa and E. coli on surfaces of hospital door handles. Hence, public education on proper personal hygiene and disinfection techniques are recommended in hospitals.

Plasmid Profile Analysis and Curing of Multidrug-Resistant Bacteria Isolated from Hospital Environmental Surfaces in Akure Metropolis, Ondo State, Nigeria

Plasmid profile analysis and curing of multidrug-resistant bacteria isolated from hospital environment in Akure metropolis, Ondo State Nigeria were investigated. Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Bacillus cereus were the bacterial isolated in the course of the research. The result revealed that Staphylococcus aureus and Pseudomonas aeruginosa showed multiple antibiotics resistance. Staphylococcus aureus and Pseudomonas aeruginosa are rapidly increasing as multidrug resistant strains worldwide. The results of antibiotics sensitivity test on the microorganisms subjected to plasmid analysis indicated that they were more susceptible to antibiotics after the plasmid curing of the microorganisms. The results from this investigative study have shown that resistance in S. aureus and P. aeruginosa are plasmid based as a result of its loss after curing.

Occurrence and clonal diversity of multidrug-resistant Klebsiella pneumoniae recovered from inanimate surfaces in Algerian hospital environment: First report of armA, qnrB and aac(6')-Ib-cr genes.

The aim of this study is to characterize the molecular support of antibiotic resistance in MDR Klebsiella pneumoniae recovered from inanimate surfaces between March 2012 to February 2014 in three teaching hospitals (Setif, Bejaia and Constantine) in Algeria. Forty-four K. pneumoniae producing ESBL were detected and blaCTX-M-15 and blaCTX-M-3 were detected respectively in 41 and 3 isolates. These K. pneumoniae isolates producing ESBL were also resistant to gentamicin (87%), tobramicin (87%), ciprofloxacin (66%) and ofloxacin (62%). Aminoglycosides resistance genes detected were 16S rRNA methylase (armA), aminoglycoside acetyl-transferase (aac(6')-Ib), aminoglycoside nucleotidyl-transferase (aadA2) and aminoglycoside, phosphoryl-transferase (ant3″Ih-aac(6')-IId). Plasmid-mediated quinolone resistance (PMQR) genes detected were aac(6')-Ib-cr (34 isolates) and qnrB genes in (34 isolates). Multilocus sequence typing (MLST) resulted in 12 different sequence types (STs) regrouped into 5 clonal complexes (CC147, CC17, CC37, CC2 and CC23), one clonal group (CG485) and 4 singletons (ST1426, ST405, ST1308, ST873). Here, we report the detection of the ESBLs encoding gene linked with plasmid-mediated quinolone resistance (PMQR) and aminoglycosides resistance recovered from inanimate surfaces in hospital environment.