Exploring Surface Cleaning Strategies in Hospital to Prevent Contact Transmission of Methicillin-Resistant Staphylococcus aureus

Details

• Personal Author:
  Jones RM ; Lei H ; Li Y
• Description:
  Background: Cleaning of environmental surfaces in hospitals is important for the control of methicillin-resistant Staphylococcus aureus (MRSA) and other hospital-acquired infections transmitted by the contact route. Guidance regarding the best approaches for cleaning, however, is limited. Methods: In this study, a mathematical model based on ordinary differential equations was constructed to study MRSA concentration dynamics on high-touch and low-touch surfaces, and on the hands and noses of two patients (in two hospitals rooms) and a health care worker in a hypothetical hospital environment. Two cleaning interventions - whole room cleaning and wipe cleaning of touched surfaces - were considered. The performance of the cleaning interventions was indicated by a reduction in MRSA on the nose of a susceptible patient, relative to no intervention. Results: Whole room cleaning just before first patient care activities of the day was more effective than whole room cleaning at other times, but even with 100% efficiency, whole room cleaning only reduced the number of MRSA transmitted to the susceptible patient by 54%. Frequent wipe cleaning of touched surfaces was shown to be more effective that whole room cleaning because surfaces are rapidly re-contaminated with MRSA after cleaning. Wipe cleaning high-touch surfaces was more effective than wipe cleaning low-touch surfaces for the same frequency of cleaning. For low wipe cleaning frequency (≤ 3 times per hour), high-touch surfaces should be targeted, but for high wipe cleaning frequency (>3 times per hour), cleaning should target high- and low-touch surfaces in proportion to the surface touch frequency. This study reproduces the observations from a field study of room cleaning, which provides support for the validity of our findings. Conclusions: Daily whole room cleaning, even with 100% cleaning efficiency, provides limited reduction in the number of MRSA transmitted to susceptible patients via the contact route; and should be supplemented with frequent targeted cleaning of high-touch surfaces, such as by a wipe or cloth containing disinfectant. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Health Care Facilities Workforce And Services Occupational Health Safety
• Keywords:
  Author Keywords: Methicillin-resistant Staphylococcus Aureus Bacterial Infections Disease Transmission Health Care Facilities High-touch Surfaces Hospital Infection Control Infectious Diseases Mathematical Model Mathematical Models Methicillin Resistant Staphylococcus Aureus MRSA Surface Cleaning

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• ISSN:
  1471-2334
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Illinois ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  85
• Volume:
  17
• Issue:
  1
• NIOSHTIC Number:
  nn:20063565
• Citation:
  BMC Infect Dis 2017 Jan; 17(1):85
• Contact Point Address:
  Hao Lei, Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China
• Email:
  u3002926@hku.hk
• Federal Fiscal Year:
  2017
• Performing Organization:
  University of Illinois at Chicago
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  BMC Infectious Diseases
• End Date:
  20290630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:165f9338bd4d70e7b2056a7473f636cacf0e394e5e022ae0deb21752192a5d1a237e45b02b7b10cd89483c0fc646d5b80868b2119eaf4774add7ffd3764c18df
• Download URL:
  https://stacks.cdc.gov/view/cdc/222152/cdc_222152_DS1.pdf
• File Type:
  [PDF - 1.10 MB ]