Microbial burden on environmental surfaces in long-term care facilities: a quantitative analysis.

Background: We conducted a quantitative analysis of the microbial burden and prevalence of epidemiologically important pathogens (EIP) found on long-term care facilities (LTCF) environmental surfaces.

Methods: Microbiological samples were collected using Rodac plates (25cm2/plate) from resident rooms and common areas in five LTCFs. EIP were defined as MRSA, VRE, C.

Evaluation of antibiotic-resistant bacteria in home kitchens and bathrooms: Is there a link between home disinfectant use and antibiotic resistance?

Objective: To determine the relationship between home disinfectant use and the prevalence of antibiotic resistance among environmental isolates of human pathogens.

Methods: Bacteria were cultured from 5 kitchen and 5 bathroom sites using quantitative methods. Antibiotic susceptibility was determined by standard methods.

Inactivation of and by ultraviolet-C.

We evaluated the ability of an ultraviolet-C (UV-C) room decontamination device to kill and . With an organic challenge (fetal calf serum), the UV-C device demonstrated the following log reductions for of 4.57 and for of 5.

Does blood on "dirty" instruments interfere with the effectiveness of sterilization technologies?

We evaluated the robustness of sterilization technologies when spores and bacteria were placed on "dirty" instruments and overlaid with blood. The results illustrate that steam sterilization is the most effective sterilization technology with the largest margin of safety, followed by ethylene oxide and hydrogen peroxide gas plasma.

Microbial Assessment of Health Care-Associated Pathogens on Various Environmental Sites in Patient Rooms After Terminal Room Disinfection.

We examined the microbial burden on hospital room environmental sites after standard (quaternary ammonium [Quat]) or enhanced disinfection (quat/ultraviolet light [UV-C], bleach, or bleach/UV-C). An enhanced terminal room disinfection reduced the microbial burden of epidemiologically important pathogens on high-touch surfaces in patient rooms, especially sites around the bed, better than standard room disinfection.

Perioperative Bacterial Contamination From Patients on Contact Precaution in Operating Room Environment.

We investigated the microbial burden on the operating room environment when patients on contact precautions for a multidrug-resistant pathogen received surgery. Our study demonstrated that the perioperative environment was contaminated with aerobic bacteria and methicillin-resistant (MRSA) after surgery, and that MRSA persisted environmentally even after cleaning and disinfection, highlighting the need for meticulous cleaning and disinfection in the perioperative environment.

Comparative evaluation of the microbicidal activity of low-temperature sterilization technologies to steam sterilization.

Objective: To compare the microbicidal activity of low-temperature sterilization technologies (vaporized hydrogen peroxide [VHP], ethylene oxide [ETO], and hydrogen peroxide gas plasma [HPGP]) to steam sterilization in the presence of salt and serum to simulate inadequate precleaning.

Methods: Test carriers were inoculated with Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, vancomycin-resistant Enterococcus, Mycobacterium terrae, Bacillus atrophaeus spores, Geobacillus stearothermophilus spores, or Clostridiodes difficile spores in the presence of salt and serum and then subjected to 4 sterilization technologies: steam, ETO, VHP and HPGP.

Results: Steam, ETO, and HPGP sterilization techniques were capable of inactivating the test organisms on stainless steel carriers with a failure rate of 0% (0 of 220), 1.

Antimicrobial activity of a continuously active disinfectant against healthcare pathogens.

A novel disinfectant studied using an EPA protocol demonstrated sustained antimicrobial activity (ie, 3-5 log10 reduction) in 5 minutes after 24 hours for Staphylococcus aureus, vancomycin-resistant Enterococcus, Candida auris, carbapenem-resistant Escherichia coli and antibiotic-susceptible E. coli, and Enterobacter spp. Only ∼2 log10 reduction occurred with carbapenem-resistant Enterobacter spp and K.

Susceptibility of Candida auris and Candida albicans to 21 germicides used in healthcare facilities.

Candida auris is an emerging fungal pathogen that is often resistant to major classes of antifungal drugs. It is considered a serious global health threat because it can cause severe infections with frequent mortality in more than a dozen countries. It can survive on healthcare environmental surfaces for at least 7 days and can cause outbreaks in healthcare facilities.

A prospective study of transmission of Multidrug-Resistant Organisms (MDROs) between environmental sites and hospitalized patients-the TransFER study.

Objective: Hospital environmental surfaces are frequently contaminated by microorganisms. However, the causal mechanism of bacterial contamination of the environment as a source of transmission is still debated. This prospective study was performed to characterize the nature of multidrug-resistant organism (MDRO) transmission between the environment and patients using standard microbiological and molecular techniques.

Antimicrobial activity of a continuous visible light disinfection system.

We evaluated the ability of high-intensity visible violet light with a peak output of 405 nm to kill epidemiologically important pathogens. The high irradiant light significantly reduced both vegetative bacteria and spores at some time points over a 72-hour exposure period.

Enhanced disinfection leads to reduction of microbial contamination and a decrease in patient colonization and infection.

In this prospective study, we monitored 4 epidemiologically important pathogens (EIPs): methicillin-resistane Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant (MDR) Acinetobacter to assess the effectiveness of 3 enhanced disinfection strategies for terminal room disinfection against standard practice. Our data demonstrated that a decrease in room contamination with EIPs of 94% was associated with a 35% decrease in subsequent patient colonization and/or infection.

Understanding the effect of ultraviolet light intensity on disinfection performance through the use of ultraviolet measurements and simulation.

We measured the disinfection of MRSA and Clostridium difficile spores using an ultraviolet C (UV-C) device, and we correlated those results to measurements and computer simulations of UV-C surface intensity. The results demonstrate both large differences in UV light intensity across various surfaces and how this leads to significant differences in disinfection.

Germicidal Activity against Carbapenem/Colistin-Resistant Enterobacteriaceae Using a Quantitative Carrier Test Method.

Susceptibility to germicides for carbapenem/colistin-resistant is poorly described. We investigated the efficacy of multiple germicides against these emerging antibiotic-resistant pathogens using the disc-based quantitative carrier test method that can produce results more similar to those encountered in health care settings than a suspension test. Our study results demonstrated that germicides commonly used in health care facilities likely will be effective against carbapenem/colistin-resistant when used appropriately in health care facilities.

Epidemiologic characteristics of health care-associated outbreaks and lessons learned from multiple outbreak investigations with a focus on the usefulness of routine molecular analysis.

Background: Single outbreaks have often been reported in health care settings, but the frequency of outbreaks at a hospital over time has not been described. We examined epidemiologic features of all health care-associated outbreak investigations at an academic hospital during a 5-year period.

Methods: Health care-associated outbreak investigations at an academic hospital (2012-2016) were retrospectively reviewed through data on comprehensive hospital-wide surveillance and pulsed-field gel electrophoresis (PFGE) analysis.

Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study.

Background: Patients admitted to hospital can acquire multidrug-resistant organisms and Clostridium difficile from inadequately disinfected environmental surfaces. We determined the effect of three enhanced strategies for terminal room disinfection (disinfection of a room between occupying patients) on acquisition and infection due to meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, C difficile, and multidrug-resistant Acinetobacter.

Methods: We did a pragmatic, cluster-randomised, crossover trial at nine hospitals in the southeastern USA.

Carbapenem-resistant Enterobacteriaceae: frequency of hospital room contamination and survival on various inoculated surfaces.

Carbapenem-resistant Enterobacteriaceae (CRE) only contaminated the environmental surfaces of rooms housing CRE colonized/infected patients infrequently (8.4%) and at low levels (average, 5.1 colony-forming units [CFU]/120 cm² per contaminated surface).