Sequential enhanced cleaning eliminates multidrug-resistant organisms in general intensive care unit of a traditional Chinese medicine hospital

Abstract Purpose Effective cleaning of surfaces within hospital wards is necessary to reduce pathogen transmission. We investigated the role of sequential enhanced cleaning by culturing pathogens from high-touch surfaces in a general intensive care unit (GICU). Methods A before-after controlled study was conducted during a 17-month period in the 25-bed GICU. The study comprised a baseline period (period 1) and four sequential tiered interventions: each patient zone was wiped with a single clean microfiber cloth daily (period 2), fluorescent markers and adenosine triphosphate (ATP) assay were used to monitor and provide feedback on the effectiveness of cleaning (period 3), wiping a single patient zone with three clean microfiber cloths daily (period 4), and withdrawal of the feedback (period 5). Results Compared with period 1, the cultures of MDROs from high-touch surfaces were reduced by 41.0% (prevalence ratio (OR) = 0.59, P < 0.001), 70.8% (OR = 0.29, P < 0.001), 82.6% (OR = 0.17, P < 0.001) and 70.8% (OR = 0.29, P < 0.0001) in the subsequent sequential interventions, respectively. Conclusion Adoption of fluorescent markers and ATP bioluminescence reduced environmental contamination. Use of three cleaning cloths for one patient zone was more effective compared with a single cloth.