The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: A randomized crossover study in critical care units in two hospitals
OBJECTIVES:To determine the effect of enhanced cleaning of the near-patient environment on the isolation of hospital pathogens from the bed area and staff hands. DESIGN:Prospective randomized crossover study over the course of 1 yr. SETTING:Intensive care units at two teaching hospitals. PATIENTS:Th...
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| Veröffentlicht in: | Critical care medicine 2011-04, Vol.39 (4), p.651-658 |
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| creator | Wilson, A. Peter R Smyth, Deborah Moore, Ginny Singleton, Julie Jackson, Richard Gant, Vanya Jeanes, Annette Shaw, Steven James, Edward Cooper, Ben Kafatos, George Cookson, Barry Singer, Mervyn Bellingan, Geoffrey |
| description | OBJECTIVES:To determine the effect of enhanced cleaning of the near-patient environment on the isolation of hospital pathogens from the bed area and staff hands.
DESIGN:Prospective randomized crossover study over the course of 1 yr.
SETTING:Intensive care units at two teaching hospitals.
PATIENTS:There were 1252 patients staying during enhanced cleaning and 1331 staying during standard cleaning.
INTERVENTIONS:In each of six 2-month periods, one unit was randomly selected for additional twice-daily enhanced cleaning of hand contact surfaces.
MEASUREMENTS AND MAIN RESULTS:Agar contact samples were taken at five sites around randomly selected bed areas, from staff hands, and from communal sites three times daily for 12 bed days per week. Patients admitted in the year commencing April 2007 were analyzed for hospital-acquired colonization and infection. Over the course of 1152 bed days, 20,736 samples were collected. Detection of environmental methicillin-resistant Staphylococcus aureus per bed-area day was reduced during enhanced cleaning phases from 82 of 561 (14.6%) to 51 of 559 (9.1%) (adjusted odds ratio, 0.59; 95% confidence interval, 0.40–0.86; p = .006). Other targeted pathogens (Acinetobacter baumannii, extended-spectrum β-lactamase-producing Gram-negative bacteria, vancomycin-resistant enterococci, and Clostridium difficile) were rarely detected. Subgroup analyses showed reduced methicillin-resistant Staphylococcus aureus contamination on doctorsʼ hands during enhanced cleaning (3 of 425; 0.7% vs. 11 of 423; 2.6%; adjusted odds ratio, 0.26; 95% confidence interval, 0.07–0.95; p = .025) and a trend to reduction on nursesʼ hands (16 of 1647; 1.0% vs. 28 of 1694; 1.7%; adjusted odds ratio 0.56; 95% confidence interval, 0.29–1.08; p = .077). All 1252 critical care patients staying during enhanced and 1,331 during standard cleaning were included, but no significant effect on patient methicillin-resistant Staphylococcus aureus acquisition was observed (adjusted odds ratio, 0.98; 95% confidence interval, 0.58–1.65; p = .93).
CONCLUSIONS:Enhanced cleaning reduced environmental contamination and hand carriage, but no significant effect was observed on patient acquisition of methicillin-resistant Staphylococcus aureus.
TRIAL REGISTRY:ISRCTN. Identifier06298448. http://www.controlled-trials.com/isrctn/. |
| doi_str_mv | 10.1097/CCM.0b013e318206bc66 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_868769162</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>868769162</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3816-8dadc57b22bbd432649e202391196ae8a8ac490fe5b40af43d381d6ffa46d0d43</originalsourceid><addsrcrecordid>eNpdUctu1DAUjRCIDoU_QMgbxCrFr3FidtUIClIRm7KOHOemMSR2sJ0ZlX_kn3pDh6mEN_Y9Og_5nqJ4zegFo7p6v9t9vaAtZQIEqzlVrVXqSbFhW0FLyrV4Wmwo1bQUUouz4kVKPyhlcluJ58UZZ1zySotN8edmAOKm2dhMQk_AD8Zb6IgdwXjnb8nB5cF5kleaz-CT2wOxJgJZvEONJzb4bCbnTXY4ocnK9WBiOSMEPqPr3sXgp_W9-pEhpNllMxJkDOEWXT-QSxKN78Lkfq_xMaQU9hBJykt3h9EIuewsak7haYXzIZzs0sviWY8XvDre58X3Tx9vdp_L629XX3aX16UVNVNl3ZnObquW87btpOBKauCUC82YVgZqUxsrNe1h20pqeik6lHWq741UHUXFefHuwXeO4dcCKTeTSxbG0XgIS2pqVVdKM8WRKR-Yf38UoW_m6CYT7xpGm7XHBnts_u8RZW-OAUs7QXcS_SsOCW-PBJNwKT3uzrr0yBO6UlTpx_xDGDPE9HNcDhCbAcyYh4biEVyqklPGqMSpXCEl7gGOc7xU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>868769162</pqid></control><display><type>article</type><title>The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: A randomized crossover study in critical care units in two hospitals</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Wilson, A. Peter R ; Smyth, Deborah ; Moore, Ginny ; Singleton, Julie ; Jackson, Richard ; Gant, Vanya ; Jeanes, Annette ; Shaw, Steven ; James, Edward ; Cooper, Ben ; Kafatos, George ; Cookson, Barry ; Singer, Mervyn ; Bellingan, Geoffrey</creator><creatorcontrib>Wilson, A. Peter R ; Smyth, Deborah ; Moore, Ginny ; Singleton, Julie ; Jackson, Richard ; Gant, Vanya ; Jeanes, Annette ; Shaw, Steven ; James, Edward ; Cooper, Ben ; Kafatos, George ; Cookson, Barry ; Singer, Mervyn ; Bellingan, Geoffrey</creatorcontrib><description>OBJECTIVES:To determine the effect of enhanced cleaning of the near-patient environment on the isolation of hospital pathogens from the bed area and staff hands.
DESIGN:Prospective randomized crossover study over the course of 1 yr.
SETTING:Intensive care units at two teaching hospitals.
PATIENTS:There were 1252 patients staying during enhanced cleaning and 1331 staying during standard cleaning.
INTERVENTIONS:In each of six 2-month periods, one unit was randomly selected for additional twice-daily enhanced cleaning of hand contact surfaces.
MEASUREMENTS AND MAIN RESULTS:Agar contact samples were taken at five sites around randomly selected bed areas, from staff hands, and from communal sites three times daily for 12 bed days per week. Patients admitted in the year commencing April 2007 were analyzed for hospital-acquired colonization and infection. Over the course of 1152 bed days, 20,736 samples were collected. Detection of environmental methicillin-resistant Staphylococcus aureus per bed-area day was reduced during enhanced cleaning phases from 82 of 561 (14.6%) to 51 of 559 (9.1%) (adjusted odds ratio, 0.59; 95% confidence interval, 0.40–0.86; p = .006). Other targeted pathogens (Acinetobacter baumannii, extended-spectrum β-lactamase-producing Gram-negative bacteria, vancomycin-resistant enterococci, and Clostridium difficile) were rarely detected. Subgroup analyses showed reduced methicillin-resistant Staphylococcus aureus contamination on doctorsʼ hands during enhanced cleaning (3 of 425; 0.7% vs. 11 of 423; 2.6%; adjusted odds ratio, 0.26; 95% confidence interval, 0.07–0.95; p = .025) and a trend to reduction on nursesʼ hands (16 of 1647; 1.0% vs. 28 of 1694; 1.7%; adjusted odds ratio 0.56; 95% confidence interval, 0.29–1.08; p = .077). All 1252 critical care patients staying during enhanced and 1,331 during standard cleaning were included, but no significant effect on patient methicillin-resistant Staphylococcus aureus acquisition was observed (adjusted odds ratio, 0.98; 95% confidence interval, 0.58–1.65; p = .93).
CONCLUSIONS:Enhanced cleaning reduced environmental contamination and hand carriage, but no significant effect was observed on patient acquisition of methicillin-resistant Staphylococcus aureus.
TRIAL REGISTRY:ISRCTN. Identifier06298448. http://www.controlled-trials.com/isrctn/.</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/CCM.0b013e318206bc66</identifier><identifier>PMID: 21242793</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</publisher><subject>Acinetobacter baumannii ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Clinical death. Palliative care. Organ gift and preservation ; Clostridium difficile ; Cross Infection - epidemiology ; Cross Infection - microbiology ; Cross Infection - prevention & control ; Cross-Over Studies ; Decontamination - methods ; Female ; Hand Disinfection - standards ; Hospitals, Teaching - standards ; Humans ; Intensive care medicine ; Intensive Care Units - standards ; Male ; Medical sciences ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged</subject><ispartof>Critical care medicine, 2011-04, Vol.39 (4), p.651-658</ispartof><rights>2011 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3816-8dadc57b22bbd432649e202391196ae8a8ac490fe5b40af43d381d6ffa46d0d43</citedby><cites>FETCH-LOGICAL-c3816-8dadc57b22bbd432649e202391196ae8a8ac490fe5b40af43d381d6ffa46d0d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23976069$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21242793$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilson, A. Peter R</creatorcontrib><creatorcontrib>Smyth, Deborah</creatorcontrib><creatorcontrib>Moore, Ginny</creatorcontrib><creatorcontrib>Singleton, Julie</creatorcontrib><creatorcontrib>Jackson, Richard</creatorcontrib><creatorcontrib>Gant, Vanya</creatorcontrib><creatorcontrib>Jeanes, Annette</creatorcontrib><creatorcontrib>Shaw, Steven</creatorcontrib><creatorcontrib>James, Edward</creatorcontrib><creatorcontrib>Cooper, Ben</creatorcontrib><creatorcontrib>Kafatos, George</creatorcontrib><creatorcontrib>Cookson, Barry</creatorcontrib><creatorcontrib>Singer, Mervyn</creatorcontrib><creatorcontrib>Bellingan, Geoffrey</creatorcontrib><title>The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: A randomized crossover study in critical care units in two hospitals</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVES:To determine the effect of enhanced cleaning of the near-patient environment on the isolation of hospital pathogens from the bed area and staff hands.
DESIGN:Prospective randomized crossover study over the course of 1 yr.
SETTING:Intensive care units at two teaching hospitals.
PATIENTS:There were 1252 patients staying during enhanced cleaning and 1331 staying during standard cleaning.
INTERVENTIONS:In each of six 2-month periods, one unit was randomly selected for additional twice-daily enhanced cleaning of hand contact surfaces.
MEASUREMENTS AND MAIN RESULTS:Agar contact samples were taken at five sites around randomly selected bed areas, from staff hands, and from communal sites three times daily for 12 bed days per week. Patients admitted in the year commencing April 2007 were analyzed for hospital-acquired colonization and infection. Over the course of 1152 bed days, 20,736 samples were collected. Detection of environmental methicillin-resistant Staphylococcus aureus per bed-area day was reduced during enhanced cleaning phases from 82 of 561 (14.6%) to 51 of 559 (9.1%) (adjusted odds ratio, 0.59; 95% confidence interval, 0.40–0.86; p = .006). Other targeted pathogens (Acinetobacter baumannii, extended-spectrum β-lactamase-producing Gram-negative bacteria, vancomycin-resistant enterococci, and Clostridium difficile) were rarely detected. Subgroup analyses showed reduced methicillin-resistant Staphylococcus aureus contamination on doctorsʼ hands during enhanced cleaning (3 of 425; 0.7% vs. 11 of 423; 2.6%; adjusted odds ratio, 0.26; 95% confidence interval, 0.07–0.95; p = .025) and a trend to reduction on nursesʼ hands (16 of 1647; 1.0% vs. 28 of 1694; 1.7%; adjusted odds ratio 0.56; 95% confidence interval, 0.29–1.08; p = .077). All 1252 critical care patients staying during enhanced and 1,331 during standard cleaning were included, but no significant effect on patient methicillin-resistant Staphylococcus aureus acquisition was observed (adjusted odds ratio, 0.98; 95% confidence interval, 0.58–1.65; p = .93).
CONCLUSIONS:Enhanced cleaning reduced environmental contamination and hand carriage, but no significant effect was observed on patient acquisition of methicillin-resistant Staphylococcus aureus.
TRIAL REGISTRY:ISRCTN. Identifier06298448. http://www.controlled-trials.com/isrctn/.</description><subject>Acinetobacter baumannii</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Clinical death. Palliative care. Organ gift and preservation</subject><subject>Clostridium difficile</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - microbiology</subject><subject>Cross Infection - prevention & control</subject><subject>Cross-Over Studies</subject><subject>Decontamination - methods</subject><subject>Female</subject><subject>Hand Disinfection - standards</subject><subject>Hospitals, Teaching - standards</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intensive Care Units - standards</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methicillin-Resistant Staphylococcus aureus</subject><subject>Middle Aged</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUctu1DAUjRCIDoU_QMgbxCrFr3FidtUIClIRm7KOHOemMSR2sJ0ZlX_kn3pDh6mEN_Y9Og_5nqJ4zegFo7p6v9t9vaAtZQIEqzlVrVXqSbFhW0FLyrV4Wmwo1bQUUouz4kVKPyhlcluJ58UZZ1zySotN8edmAOKm2dhMQk_AD8Zb6IgdwXjnb8nB5cF5kleaz-CT2wOxJgJZvEONJzb4bCbnTXY4ocnK9WBiOSMEPqPr3sXgp_W9-pEhpNllMxJkDOEWXT-QSxKN78Lkfq_xMaQU9hBJykt3h9EIuewsak7haYXzIZzs0sviWY8XvDre58X3Tx9vdp_L629XX3aX16UVNVNl3ZnObquW87btpOBKauCUC82YVgZqUxsrNe1h20pqeik6lHWq741UHUXFefHuwXeO4dcCKTeTSxbG0XgIS2pqVVdKM8WRKR-Yf38UoW_m6CYT7xpGm7XHBnts_u8RZW-OAUs7QXcS_SsOCW-PBJNwKT3uzrr0yBO6UlTpx_xDGDPE9HNcDhCbAcyYh4biEVyqklPGqMSpXCEl7gGOc7xU</recordid><startdate>201104</startdate><enddate>201104</enddate><creator>Wilson, A. Peter R</creator><creator>Smyth, Deborah</creator><creator>Moore, Ginny</creator><creator>Singleton, Julie</creator><creator>Jackson, Richard</creator><creator>Gant, Vanya</creator><creator>Jeanes, Annette</creator><creator>Shaw, Steven</creator><creator>James, Edward</creator><creator>Cooper, Ben</creator><creator>Kafatos, George</creator><creator>Cookson, Barry</creator><creator>Singer, Mervyn</creator><creator>Bellingan, Geoffrey</creator><general>by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201104</creationdate><title>The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: A randomized crossover study in critical care units in two hospitals</title><author>Wilson, A. Peter R ; Smyth, Deborah ; Moore, Ginny ; Singleton, Julie ; Jackson, Richard ; Gant, Vanya ; Jeanes, Annette ; Shaw, Steven ; James, Edward ; Cooper, Ben ; Kafatos, George ; Cookson, Barry ; Singer, Mervyn ; Bellingan, Geoffrey</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3816-8dadc57b22bbd432649e202391196ae8a8ac490fe5b40af43d381d6ffa46d0d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acinetobacter baumannii</topic><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Clinical death. Palliative care. Organ gift and preservation</topic><topic>Clostridium difficile</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - microbiology</topic><topic>Cross Infection - prevention & control</topic><topic>Cross-Over Studies</topic><topic>Decontamination - methods</topic><topic>Female</topic><topic>Hand Disinfection - standards</topic><topic>Hospitals, Teaching - standards</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intensive Care Units - standards</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methicillin-Resistant Staphylococcus aureus</topic><topic>Middle Aged</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilson, A. Peter R</creatorcontrib><creatorcontrib>Smyth, Deborah</creatorcontrib><creatorcontrib>Moore, Ginny</creatorcontrib><creatorcontrib>Singleton, Julie</creatorcontrib><creatorcontrib>Jackson, Richard</creatorcontrib><creatorcontrib>Gant, Vanya</creatorcontrib><creatorcontrib>Jeanes, Annette</creatorcontrib><creatorcontrib>Shaw, Steven</creatorcontrib><creatorcontrib>James, Edward</creatorcontrib><creatorcontrib>Cooper, Ben</creatorcontrib><creatorcontrib>Kafatos, George</creatorcontrib><creatorcontrib>Cookson, Barry</creatorcontrib><creatorcontrib>Singer, Mervyn</creatorcontrib><creatorcontrib>Bellingan, Geoffrey</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilson, A. Peter R</au><au>Smyth, Deborah</au><au>Moore, Ginny</au><au>Singleton, Julie</au><au>Jackson, Richard</au><au>Gant, Vanya</au><au>Jeanes, Annette</au><au>Shaw, Steven</au><au>James, Edward</au><au>Cooper, Ben</au><au>Kafatos, George</au><au>Cookson, Barry</au><au>Singer, Mervyn</au><au>Bellingan, Geoffrey</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: A randomized crossover study in critical care units in two hospitals</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>2011-04</date><risdate>2011</risdate><volume>39</volume><issue>4</issue><spage>651</spage><epage>658</epage><pages>651-658</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVES:To determine the effect of enhanced cleaning of the near-patient environment on the isolation of hospital pathogens from the bed area and staff hands.
DESIGN:Prospective randomized crossover study over the course of 1 yr.
SETTING:Intensive care units at two teaching hospitals.
PATIENTS:There were 1252 patients staying during enhanced cleaning and 1331 staying during standard cleaning.
INTERVENTIONS:In each of six 2-month periods, one unit was randomly selected for additional twice-daily enhanced cleaning of hand contact surfaces.
MEASUREMENTS AND MAIN RESULTS:Agar contact samples were taken at five sites around randomly selected bed areas, from staff hands, and from communal sites three times daily for 12 bed days per week. Patients admitted in the year commencing April 2007 were analyzed for hospital-acquired colonization and infection. Over the course of 1152 bed days, 20,736 samples were collected. Detection of environmental methicillin-resistant Staphylococcus aureus per bed-area day was reduced during enhanced cleaning phases from 82 of 561 (14.6%) to 51 of 559 (9.1%) (adjusted odds ratio, 0.59; 95% confidence interval, 0.40–0.86; p = .006). Other targeted pathogens (Acinetobacter baumannii, extended-spectrum β-lactamase-producing Gram-negative bacteria, vancomycin-resistant enterococci, and Clostridium difficile) were rarely detected. Subgroup analyses showed reduced methicillin-resistant Staphylococcus aureus contamination on doctorsʼ hands during enhanced cleaning (3 of 425; 0.7% vs. 11 of 423; 2.6%; adjusted odds ratio, 0.26; 95% confidence interval, 0.07–0.95; p = .025) and a trend to reduction on nursesʼ hands (16 of 1647; 1.0% vs. 28 of 1694; 1.7%; adjusted odds ratio 0.56; 95% confidence interval, 0.29–1.08; p = .077). All 1252 critical care patients staying during enhanced and 1,331 during standard cleaning were included, but no significant effect on patient methicillin-resistant Staphylococcus aureus acquisition was observed (adjusted odds ratio, 0.98; 95% confidence interval, 0.58–1.65; p = .93).
CONCLUSIONS:Enhanced cleaning reduced environmental contamination and hand carriage, but no significant effect was observed on patient acquisition of methicillin-resistant Staphylococcus aureus.
TRIAL REGISTRY:ISRCTN. Identifier06298448. http://www.controlled-trials.com/isrctn/.</abstract><cop>Hagerstown, MD</cop><pub>by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</pub><pmid>21242793</pmid><doi>10.1097/CCM.0b013e318206bc66</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0090-3493 |
| ispartof | Critical care medicine, 2011-04, Vol.39 (4), p.651-658 |
| issn | 0090-3493 1530-0293 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_868769162 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Acinetobacter baumannii Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Clinical death. Palliative care. Organ gift and preservation Clostridium difficile Cross Infection - epidemiology Cross Infection - microbiology Cross Infection - prevention & control Cross-Over Studies Decontamination - methods Female Hand Disinfection - standards Hospitals, Teaching - standards Humans Intensive care medicine Intensive Care Units - standards Male Medical sciences Methicillin-Resistant Staphylococcus aureus Middle Aged |
| title | The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: A randomized crossover study in critical care units in two hospitals |
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