Impact of terminal cleaning in rooms previously occupied by patients with healthcare-associated infections
Healthcare associated infections (HAIs) are costly but preventable. A limited understanding of the effects of environmental cleaning on the riskiest HAI associated pathogens is a current challenge in HAI prevention. This project aimed to quantify the effects of terminal hospital cleaning practices o...
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| Veröffentlicht in: | PloS one 2024-07, Vol.19 (7), p.e0305083 |
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| creator | Verhougstraete, Marc Cooksey, Emily Walker, Jennifer-Pearce Wilson, Amanda M Lewis, Madeline S Yoder, Aaron Elizondo-Craig, Gabriela Almoslem, Munthir Forysiak, Emily Weir, Mark H |
| description | Healthcare associated infections (HAIs) are costly but preventable. A limited understanding of the effects of environmental cleaning on the riskiest HAI associated pathogens is a current challenge in HAI prevention. This project aimed to quantify the effects of terminal hospital cleaning practices on HAI pathogens via environmental sampling in three hospitals located throughout the United States. Surfaces were swabbed from 36 occupied patient rooms with a laboratory-confirmed, hospital- or community-acquired infection of at least one of the four pathogens of interest (i.e., Acinetobacter baumannii (A. baumannii), methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus faecalis/faecium (VRE), and Clostridioides difficile (C. difficile)). Six nonporous, high touch surfaces (i.e., chair handrail, bed handrail, nurse call button, desk surface, bathroom counter near the sink, and a grab bar near the toilet) were sampled in each room for Adenosine Triphosphate (ATP) and the four pathogens of interest before and after terminal cleaning. The four pathogens of interest were detected on surfaces before and after terminal cleaning, but their levels were generally reduced. Overall, C. difficile was confirmed on the desk (n = 2), while MRSA (n = 24) and VRE (n = 25) were confirmed on all surface types before terminal cleaning. After cleaning, only MRSA (n = 6) on bed handrail, chair handrail, and nurse call button and VRE (n = 5) on bathroom sink, bed handrail, nurse call button, toilet grab bar, and C. difficile (n = 1) were confirmed. At 2 of the 3 hospitals, pathogens were generally reduced by >99% during terminal cleaning. One hospital showed that VRE increased after terminal cleaning, MRSA was reduced by 73% on the nurse call button, and VRE was reduced by only 50% on the bathroom sink. ATP detections did not correlate with any pathogen concentration. This study highlights the importance of terminal cleaning and indicates room for improvement in cleaning practices to reduce surface contamination throughout hospital rooms. |
| doi_str_mv | 10.1371/journal.pone.0305083 |
| format | Article |
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A limited understanding of the effects of environmental cleaning on the riskiest HAI associated pathogens is a current challenge in HAI prevention. This project aimed to quantify the effects of terminal hospital cleaning practices on HAI pathogens via environmental sampling in three hospitals located throughout the United States. Surfaces were swabbed from 36 occupied patient rooms with a laboratory-confirmed, hospital- or community-acquired infection of at least one of the four pathogens of interest (i.e., Acinetobacter baumannii (A. baumannii), methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus faecalis/faecium (VRE), and Clostridioides difficile (C. difficile)). Six nonporous, high touch surfaces (i.e., chair handrail, bed handrail, nurse call button, desk surface, bathroom counter near the sink, and a grab bar near the toilet) were sampled in each room for Adenosine Triphosphate (ATP) and the four pathogens of interest before and after terminal cleaning. The four pathogens of interest were detected on surfaces before and after terminal cleaning, but their levels were generally reduced. Overall, C. difficile was confirmed on the desk (n = 2), while MRSA (n = 24) and VRE (n = 25) were confirmed on all surface types before terminal cleaning. After cleaning, only MRSA (n = 6) on bed handrail, chair handrail, and nurse call button and VRE (n = 5) on bathroom sink, bed handrail, nurse call button, toilet grab bar, and C. difficile (n = 1) were confirmed. At 2 of the 3 hospitals, pathogens were generally reduced by >99% during terminal cleaning. One hospital showed that VRE increased after terminal cleaning, MRSA was reduced by 73% on the nurse call button, and VRE was reduced by only 50% on the bathroom sink. ATP detections did not correlate with any pathogen concentration. This study highlights the importance of terminal cleaning and indicates room for improvement in cleaning practices to reduce surface contamination throughout hospital rooms.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0305083</identifier><identifier>PMID: 38985740</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acinetobacter baumannii ; Acinetobacter baumannii - isolation & purification ; Adenosine triphosphate ; Antibiotics ; ATP ; Bathrooms ; Biology and life sciences ; Cellulose ; Cleaning ; Clostridioides difficile ; Clostridioides difficile - isolation & purification ; Compliance ; Cross infection ; Cross Infection - microbiology ; Cross Infection - prevention & control ; Desks ; Drug resistance ; Drug resistance in microorganisms ; Enterococcus faecalis ; Environmental effects ; Environmental monitoring ; Evaluation ; Handrails ; Health aspects ; Health care ; Hospital patients ; Hospitals ; Housekeeping, Hospital ; Humans ; Hygiene ; Infection ; Infection Control - methods ; Medical research ; Medicine and health sciences ; Medicine, Experimental ; Methicillin ; Methicillin-Resistant Staphylococcus aureus - isolation & purification ; Methods ; Microorganisms ; Muscle proteins ; Nosocomial infections ; Nurses ; Pathogens ; Patients ; Patients' Rooms ; People and Places ; Prevention ; Public health ; Social aspects ; Staphylococcus aureus ; Staphylococcus aureus infections ; Staphylococcus infections ; Surfactants ; Vancomycin ; Vancomycin-Resistant Enterococci - isolation & purification</subject><ispartof>PloS one, 2024-07, Vol.19 (7), p.e0305083</ispartof><rights>Copyright: © 2024 Verhougstraete et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Verhougstraete et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Verhougstraete et al 2024 Verhougstraete et al</rights><rights>2024 Verhougstraete et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c572t-31b770022263b38df9e97aeff36750a64aeb40b88b0f6ccd76c9b5850b03da3e3</cites><orcidid>0000-0003-4154-7531</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236128/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236128/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38985740$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Klein, Eili Y.</contributor><creatorcontrib>Verhougstraete, Marc</creatorcontrib><creatorcontrib>Cooksey, Emily</creatorcontrib><creatorcontrib>Walker, Jennifer-Pearce</creatorcontrib><creatorcontrib>Wilson, Amanda M</creatorcontrib><creatorcontrib>Lewis, Madeline S</creatorcontrib><creatorcontrib>Yoder, Aaron</creatorcontrib><creatorcontrib>Elizondo-Craig, Gabriela</creatorcontrib><creatorcontrib>Almoslem, Munthir</creatorcontrib><creatorcontrib>Forysiak, Emily</creatorcontrib><creatorcontrib>Weir, Mark H</creatorcontrib><title>Impact of terminal cleaning in rooms previously occupied by patients with healthcare-associated infections</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Healthcare associated infections (HAIs) are costly but preventable. A limited understanding of the effects of environmental cleaning on the riskiest HAI associated pathogens is a current challenge in HAI prevention. This project aimed to quantify the effects of terminal hospital cleaning practices on HAI pathogens via environmental sampling in three hospitals located throughout the United States. Surfaces were swabbed from 36 occupied patient rooms with a laboratory-confirmed, hospital- or community-acquired infection of at least one of the four pathogens of interest (i.e., Acinetobacter baumannii (A. baumannii), methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus faecalis/faecium (VRE), and Clostridioides difficile (C. difficile)). Six nonporous, high touch surfaces (i.e., chair handrail, bed handrail, nurse call button, desk surface, bathroom counter near the sink, and a grab bar near the toilet) were sampled in each room for Adenosine Triphosphate (ATP) and the four pathogens of interest before and after terminal cleaning. The four pathogens of interest were detected on surfaces before and after terminal cleaning, but their levels were generally reduced. Overall, C. difficile was confirmed on the desk (n = 2), while MRSA (n = 24) and VRE (n = 25) were confirmed on all surface types before terminal cleaning. After cleaning, only MRSA (n = 6) on bed handrail, chair handrail, and nurse call button and VRE (n = 5) on bathroom sink, bed handrail, nurse call button, toilet grab bar, and C. difficile (n = 1) were confirmed. At 2 of the 3 hospitals, pathogens were generally reduced by >99% during terminal cleaning. One hospital showed that VRE increased after terminal cleaning, MRSA was reduced by 73% on the nurse call button, and VRE was reduced by only 50% on the bathroom sink. ATP detections did not correlate with any pathogen concentration. This study highlights the importance of terminal cleaning and indicates room for improvement in cleaning practices to reduce surface contamination throughout hospital rooms.</description><subject>Acinetobacter baumannii</subject><subject>Acinetobacter baumannii - isolation & purification</subject><subject>Adenosine triphosphate</subject><subject>Antibiotics</subject><subject>ATP</subject><subject>Bathrooms</subject><subject>Biology and life sciences</subject><subject>Cellulose</subject><subject>Cleaning</subject><subject>Clostridioides difficile</subject><subject>Clostridioides difficile - isolation & purification</subject><subject>Compliance</subject><subject>Cross infection</subject><subject>Cross Infection - microbiology</subject><subject>Cross Infection - prevention & control</subject><subject>Desks</subject><subject>Drug resistance</subject><subject>Drug resistance in microorganisms</subject><subject>Enterococcus faecalis</subject><subject>Environmental effects</subject><subject>Environmental monitoring</subject><subject>Evaluation</subject><subject>Handrails</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Hospital patients</subject><subject>Hospitals</subject><subject>Housekeeping, Hospital</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Infection</subject><subject>Infection Control - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Verhougstraete, Marc</au><au>Cooksey, Emily</au><au>Walker, Jennifer-Pearce</au><au>Wilson, Amanda M</au><au>Lewis, Madeline S</au><au>Yoder, Aaron</au><au>Elizondo-Craig, Gabriela</au><au>Almoslem, Munthir</au><au>Forysiak, Emily</au><au>Weir, Mark H</au><au>Klein, Eili Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of terminal cleaning in rooms previously occupied by patients with healthcare-associated infections</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-07-10</date><risdate>2024</risdate><volume>19</volume><issue>7</issue><spage>e0305083</spage><pages>e0305083-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Healthcare associated infections (HAIs) are costly but preventable. A limited understanding of the effects of environmental cleaning on the riskiest HAI associated pathogens is a current challenge in HAI prevention. This project aimed to quantify the effects of terminal hospital cleaning practices on HAI pathogens via environmental sampling in three hospitals located throughout the United States. Surfaces were swabbed from 36 occupied patient rooms with a laboratory-confirmed, hospital- or community-acquired infection of at least one of the four pathogens of interest (i.e., Acinetobacter baumannii (A. baumannii), methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus faecalis/faecium (VRE), and Clostridioides difficile (C. difficile)). Six nonporous, high touch surfaces (i.e., chair handrail, bed handrail, nurse call button, desk surface, bathroom counter near the sink, and a grab bar near the toilet) were sampled in each room for Adenosine Triphosphate (ATP) and the four pathogens of interest before and after terminal cleaning. The four pathogens of interest were detected on surfaces before and after terminal cleaning, but their levels were generally reduced. Overall, C. difficile was confirmed on the desk (n = 2), while MRSA (n = 24) and VRE (n = 25) were confirmed on all surface types before terminal cleaning. After cleaning, only MRSA (n = 6) on bed handrail, chair handrail, and nurse call button and VRE (n = 5) on bathroom sink, bed handrail, nurse call button, toilet grab bar, and C. difficile (n = 1) were confirmed. At 2 of the 3 hospitals, pathogens were generally reduced by >99% during terminal cleaning. One hospital showed that VRE increased after terminal cleaning, MRSA was reduced by 73% on the nurse call button, and VRE was reduced by only 50% on the bathroom sink. ATP detections did not correlate with any pathogen concentration. This study highlights the importance of terminal cleaning and indicates room for improvement in cleaning practices to reduce surface contamination throughout hospital rooms.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38985740</pmid><doi>10.1371/journal.pone.0305083</doi><tpages>e0305083</tpages><orcidid>https://orcid.org/0000-0003-4154-7531</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-07, Vol.19 (7), p.e0305083 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3078425136 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acinetobacter baumannii Acinetobacter baumannii - isolation & purification Adenosine triphosphate Antibiotics ATP Bathrooms Biology and life sciences Cellulose Cleaning Clostridioides difficile Clostridioides difficile - isolation & purification Compliance Cross infection Cross Infection - microbiology Cross Infection - prevention & control Desks Drug resistance Drug resistance in microorganisms Enterococcus faecalis Environmental effects Environmental monitoring Evaluation Handrails Health aspects Health care Hospital patients Hospitals Housekeeping, Hospital Humans Hygiene Infection Infection Control - methods Medical research Medicine and health sciences Medicine, Experimental Methicillin Methicillin-Resistant Staphylococcus aureus - isolation & purification Methods Microorganisms Muscle proteins Nosocomial infections Nurses Pathogens Patients Patients' Rooms People and Places Prevention Public health Social aspects Staphylococcus aureus Staphylococcus aureus infections Staphylococcus infections Surfactants Vancomycin Vancomycin-Resistant Enterococci - isolation & purification |
| title | Impact of terminal cleaning in rooms previously occupied by patients with healthcare-associated infections |
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