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Comparison of Fluorescent Marker Systems with 2 Quantitative Methods of Assessing Terminal Cleaning Practices

Published online by Cambridge University Press:  02 January 2015

John M. Boyce ,
Nancy L. Havill ,
Heather L. Havill ,
Elise Mangione ,
Diane G. Dumigan  and
Brent A. Moore
John M. Boyce*
Affiliation:
Hospital of Saint Raphael, New Haven, Connecticut Yale University School of Medicine, New Haven, Connecticut
Nancy L. Havill
Affiliation:
Hospital of Saint Raphael, New Haven, Connecticut
Heather L. Havill
Affiliation:
Hospital of Saint Raphael, New Haven, Connecticut
Elise Mangione
Affiliation:
Hospital of Saint Raphael, New Haven, Connecticut
Diane G. Dumigan
Affiliation:
Hospital of Saint Raphael, New Haven, Connecticut
Brent A. Moore
Affiliation:
Yale University School of Medicine, New Haven, Connecticut
*
Hospital of Saint Raphael, New Haven, CT 06511 (jboyce@srhs.org)
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Abstract

Objective.

To compare fluorescent markers with aerobic colony counts (ACCs) and an adenosine triphosphate (ATP) bioluminescence assay system for assessing terminal cleaning practices.

Design.

A prospective observational survey.

Setting.

A 500-bed university-affiliated community teaching hospital.

Methods.

In a convenience sample of 100 hospital rooms, 5 high-touch surfaces were marked with fluorescent markers before terminal cleaning and checked after cleaning to see whether the marker had been entirely or partially removed. ACC and ATP readings were performed on the same surfaces before and after terminal cleaning.

Results.

Overall, 378 (76%) of 500 surfaces were classified as having been cleaned according to fluorescent markers, compared with 384 (77%) according to ACC criteria and 225 (45%) according to ATP criteria. Of 382 surfaces classified as not clean according to ATP criteria before terminal cleaning, those with the marker removed were significantly more likely than those with the marker partially removed to be classified as clean according to ATP criteria (P = .003).

Conclusions.

Fluorescent markers are useful in determining how frequently high-touch surfaces are wiped during terminal cleaning. However, contaminated surfaces classified as clean according to fluorescent marker criteria after terminal cleaning were significantly less likely to be classified as clean according to ACC and ATP assays.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 32 , Issue 12 , December 2011 , pp. 1187 - 1193
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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References

1. Boyce, JM, Potter-Bynoe, G, Chenevert, C, King, T. Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications. Infect Control Hosp Epidemiol 1997;18:622–627.CrossRefGoogle ScholarPubMed
2. Samore, MH, Venkataraman, L, Degirolami, PC, Levin, E, Karchmer, AW. Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea. Am J Med 1996;100:32–40.Google Scholar
3. Bhalla, A, Pultz, NJ, Gries, DM, et al. Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients. Infect Control Hosp Epidemiol 2004; 25:164–167.CrossRefGoogle ScholarPubMed
4. Hayden, MK, Blom, DW, Lyle, EA, Moore, CG, Weinstein, RA. Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant enterococcus or the colonized patient's environment. Infect Control Hosp Epidemiol 2008;29:149–154.CrossRefGoogle ScholarPubMed
5. Martinez, JA, Ruthazer, R, Hansjosten, K, Barefoot, L, Snydman, DR. Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci by in-patients treated in a medical intensive care unit. Arch Intern Med 2003; 163:1905–1912.CrossRefGoogle Scholar
6. Huang, SS, Datta, R, Piatt, R. Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch Intern Med 2006;166: 1945–1951.CrossRefGoogle ScholarPubMed
7. Drees, M, Snydman, DR, Schmid, CH, et al. Prior environmental contamination increases the risk of acquisition of vancomycin-resistant enterococci. Clin Infect Dis 2008;46:678–685.Google Scholar
8. Passaretti, C, Otter, JA, Lipsett, P, et al. Adherence to hydrogen peroxide vapor (HPV) decontamination reduces VRE acquisition in high-risk units. In: Program and abstracts of the 48th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology, 2008. Abstract K-4124b.Google Scholar
9. Shaughnessy, M, Micielli, R, Depestel, D, et al. Evaluation of hospital room assignment and acquisition of Clostridium difficile associated diarrhea. In: Program and abstracts of the 48th Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC: American Society for Microbiology, 2008. Abstract K-4194.Google Scholar
10. Griffith, CJ, Cooper, RA, Gilmore, J, Davies, C, Lewis, M. An evaluation of hospital cleaning regimes and standards. J Hosp Infect 2000;45:19–28.CrossRefGoogle ScholarPubMed
11. Malik, RE, Cooper, RA, Griffith, CJ. Use of audit tools to evaluate the efficacy of cleaning systems in hospitals. Am J Infect Control 2003;31:181–187.CrossRefGoogle ScholarPubMed
12. Dancer, SJ. How do we assess hospital cleaning? a proposal for microbiological standards for surface hygiene in hospitals. J Hosp Infect 2004;56:10–15.CrossRefGoogle ScholarPubMed
13. White, LF, Dancer, SJ, Robertson, C, McDonald, J. Are hygiene Standards useful in assessing infection risk? Am J Infect Control 2008;36:381–384.CrossRefGoogle ScholarPubMed
14. Lewis, T, Griffith, C, Gallo, M, Weinbren, M. A modified ATP benchmark for evaluating the cleaning of some hospital environmental surfaces. J Hosp Infect 2008;69:156–163.CrossRefGoogle ScholarPubMed
15. Sherlock, O, O'Connell, N, Creamer, E, Humphreys, H. Is it really clean? an evaluation of the efficacy of four methods for determining hospital cleanliness. J Hosp Infect 2009;72:140–146.Google Scholar
16. Boyce, JM, Havill, NL, Lipka, A, Havill, H, Rizvani, R. Variations in hospital daily cleaning practices. Infect Control Hosp Epidemiol 2010;31:99–101.CrossRefGoogle ScholarPubMed
17. Carling, PC, Briggs, JL, Perkins, J, Highlander, D. Improved cleaning of patient rooms using a new targeting method. Clin Infect Dis 2006;42:385–388.Google Scholar
18. Carling, PC, Parry, MF, Von Beheren, SM; Healthcare Environmental Hygiene Study Group. Identifying opportunities to enhance environmental cleaning in 23 acute care hospitals. Infect Control Hosp Epidemiol 2008;29:1–7.Google Scholar
19. Carling, PC, Von Beheren, S, Kim, P, Woods, C; Healthcare Environmental Hygiene Study Group. Intensive care unit environment cleaning: an evaluation in sixteen hospitals using a novel assessment tool. J Hosp Infect 2008;68:39–44.CrossRefGoogle ScholarPubMed
20. Goodman, ER, Platt, R, Bass, R, Onderdon, AB, Yokoe, DS, Huang, SS. Impact of an environmental cleaning intervention on the presence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on surfaces in intenstive care unit rooms. Infect Control Hosp Epidemiol 2008;29:593–599.CrossRefGoogle Scholar
21. Carling, PC, Briggs, J, Hylander, D, Perkins, J. An evaluation of patient area cleaning in 3 hospitals using a novel targeting methodology. Am J Infect Control 2006;34:513–519.Google Scholar
22. Boyce, JM, Havill, NL, Dumigan, DG, Golebiewski, M, Balogun, O, Rizvani, R. Monitoring the effectiveness of hospital cleaning practices using an ATP bioluminescence assay. Infect Control Hosp Epidemiol 2009;30:9998–9999.CrossRefGoogle Scholar
23. Moore, G, Smyth, D, Singleton, J, Wilson, P. The use of adenosine triphosphate bioluminescence to assess the efficacy of a modified cleaning program implemented within an intensive care setting. Am J Infect Control 2010;38:617–622.Google Scholar
24. Aycicek, H, Oguz, U, Karri, K. Comparison of results of ATP bioluminescence and traditional hygiene swabbing methods for the determination of surface cleanliness at a hospital kitchen. Int J Hyg Environ Health 2006;209:203–206.Google Scholar
25. Poulis, JA, de Pijper, M, Mossel, DA, Dekkers, PP. Assessment of cleaning and disinfection in the food industry with the rapid ATP-bioluminescence technique combined with the tissue fluid contamination test and a conventional microbiological method. Int J Food Microbiol 1993;20:109–116.Google Scholar
26. Mulvey, D, Redding, P, Robertson, C, et al. Finding a benchmark for monitoring hospital cleanliness. J Hosp Infect 2011 ;77:25–30.CrossRefGoogle ScholarPubMed