Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study
Background Increasing hospital-acquired infections have generated much attention over the last decade. There is evidence that hygienic cleaning has a role in the control of hospital-acquired infections. This study aimed to evaluate the potential impact of one additional cleaner by using microbiologi...
Uloženo v:
| Vydáno v: | BMC medicine Ročník 7; číslo 1; s. 28 |
|---|---|
| Hlavní autoři: | , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
London
BioMed Central
08.06.2009
BioMed Central Ltd BMC |
| Témata: | |
| ISSN: | 1741-7015, 1741-7015 |
| On-line přístup: | Získat plný text |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Shrnutí: | Background
Increasing hospital-acquired infections have generated much attention over the last decade. There is evidence that hygienic cleaning has a role in the control of hospital-acquired infections. This study aimed to evaluate the potential impact of one additional cleaner by using microbiological standards based on aerobic colony counts and the presence of
Staphylococcus aureus
including meticillin-resistant
S. aureus
.
Methods
We introduced an additional cleaner into two matched wards from Monday to Friday, with each ward receiving enhanced cleaning for six months in a cross-over design. Ten hand-touch sites on both wards were screened weekly using standardised methods and patients were monitored for meticillin-resistant
S. aureus
infection throughout the year-long study. Patient and environmental meticillin-resistant
S. aureus
isolates were characterised using molecular methods in order to investigate temporal and clonal relationships.
Results
Enhanced cleaning was associated with a 32.5% reduction in levels of microbial contamination at hand-touch sites when wards received enhanced cleaning (
P
< 0.0001: 95% CI 20.2%, 42.9%). Near-patient sites (lockers, overbed tables and beds) were more frequently contaminated with meticillin-resistant
S. aureus
/
S. aureus
than sites further from the patient (
P
= 0.065). Genotyping identified indistinguishable strains from both hand-touch sites and patients. There was a 26.6% reduction in new meticillin-resistant
S. aureus
infections on the wards receiving extra cleaning, despite higher meticillin-resistant
S. aureus
patient-days and bed occupancy rates during enhanced cleaning periods (
P
= 0.032: 95% CI 7.7%, 92.3%). Adjusting for meticillin-resistant
S. aureus
patient-days and based upon nine new meticillin-resistant
S. aureus
infections seen during routine cleaning, we expected 13 new infections during enhanced cleaning periods rather than the four that actually occurred. Clusters of new meticillin-resistant
S. aureus
infections were identified 2 to 4 weeks after the cleaner left both wards. Enhanced cleaning saved the hospital £30,000 to £70,000.
Conclusion
Introducing one extra cleaner produced a measurable effect on the clinical environment, with apparent benefit to patients regarding meticillin-resistant
S. aureus
infection. Molecular epidemiological methods supported the possibility that patients acquired meticillin-resistant
S. aureus
from environmental sources. These findings suggest that additional research is warranted to further clarify the environmental, clinical and economic impact of enhanced hygienic cleaning as a component in the control of hospital-acquired infection. |
|---|---|
| Bibliografie: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 1741-7015 1741-7015 |
| DOI: | 10.1186/1741-7015-7-28 |