Is the Patient Environment Clean?
Studies show that current room cleaning methods are inadequate. On average, about 34% of high-touch surfaces are cleaned at terminal clean. After cleaning, 71% of VRE occupied rooms and 78% of C. diff occupied rooms still tested positive for VRE or C. diff. Even after four rounds of disinfection with bleach, 25% of rooms were still contaminated with MRSA and Acinetobacter baumanii.
Sources: Carling PC. Infection Control and Hospital Epidemiology. 29(1), 1-7. Eckstein BC. BMC Infectious Diseases, 7, 61. doi: 1471-2334-7-61. Manian F. ICHE, 32(7), 67-72.
What is the Risk?
The acquisition risk increased if the previous room occupant was infected or colonized. Prior room occupants infected or colonized with VRE increased the risk of VRE acquisition for the next occupant (a hazard ratio of 3.8). Also, positive VRE room cultures increased the risk of VRE acquisition (a hazard ratio of 4.4). Prior room occupants infected or colonized with MRSA increased the risk of MRSA acquisition by at least 40 percent. At least 12% of acquired MRSA infections were attributed to the environment. Prior room occupants infected or colonized with C. diff increased the risk of C. diff acquisition (a hazard ratio of 2.34).
Sources: Hardy, KJ. Infect Control Hosp Epidemiol. 2006 Feb;27(2):127-32. Drees, M. Clin Infect Dis. 2008 Mar 1;46(5):678-85. Huang, SS. Arch Intern Med. 2006 Oct 9;166(18):1945-51. Shaugnessy M, et al. ICHE. Vol. 32, No. 3, Marach 2011.
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