A change in cleaning can reduce environmental bacterial contamination

Abstract number: 1134_04_252

Hardy K.J., Oppenheim B.A., Gao F., Hawkey P.M.

Objectives:  

To determine the levels of total bacterial and methicillin resistant Staphylococcus aureus (MRSA) environmental contamination of an Intensive Care Unit (ICU), and to evaluate the effect of measures introduced to reduce the bacterial burden.

Methods:  

The counts of MRSA and total bacteria were determined before and after cleaning on an ICU on 6 occasions. On each screen 4 samples were taken from each of the bed spaces (under the bed, the workstation, a ledge behind the bed space and the monitor) and MRSA detected using broth enrichment. Total bacterial counts were determined for under the bed and workstation using RODAC plates. Evaluation of the results demonstrated that cleaning was not effective, therefore a change in the cleaning product and positioning of the product within the bed space was implemented. The environment was sampled before and after cleaning as above on a further 11 occasions to determine the effect.

Results:  

The six evaluations of the cleaning regime which was in place showed higher levels of environmental contamination with MRSA after cleaning on 3 (50%) occasions. When a change in cleaning was implemented higher levels of MRSA after cleaning were only found on 1 (9%) occasion. Before a change in cleaning total bacterial counts were higher under beds after cleaning on 42.6% (20/47) occasions and on the workstations on 53.1% (25/47) occasions. After a change in cleaning protocol these rates fell to 27.7% (23/83) and 31.3% (26/83) for under the bed and workstation respectively. In addition not only was a change in the total bacterial counts after cleaning observed, but the overall counts were lower for both under the bed and workstation.

Conclusions:  

The cleaning on ICU was shown to be ineffective in removal of bacterial contamination. A change in cleaning protocol resulted in an increased effectiveness of cleaning, thereby lowering the total bacterial burden and decreasing the opportunities for transmission to patients.