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Isolation of Acinetobacter baumannii Complex and Methicillin-Resistant Staphylococcus aureus from Hospital Rooms Following Terminal Cleaning and Disinfection: Can We Do Better?

Published online by Cambridge University Press:  02 January 2015

Farrin A. Manian ,
Sandra Griesenauer ,
Diane Senkel ,
Janice M. Setzer ,
Sara A. Doll ,
Annie M. Perry  and
Michelle Wiechens
Farrin A. Manian*
Affiliation:
Division of Infectious Diseases, St. John's Mercy Medical Center, St. Louis, Missouri Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Sandra Griesenauer
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Diane Senkel
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Janice M. Setzer
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Sara A. Doll
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Annie M. Perry
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
Michelle Wiechens
Affiliation:
Department of Infection Control, St. John's Mercy Medical Center, St. Louis, Missouri
*
St. John's Mercy Medical Center, 621 South New Ballas Road, 7018B, St. Louis, Missouri 63141 (farrinman@gmail.com)
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Abstract

Objective.

To study the frequency of isolation of Acinetobacter baumannii complex (ABC) and methicillin-resistant Staphylococcus aureus (MRSA) from surfaces of rooms newly vacated by patients with multidrug-resistant (MDR) ABC following various rounds of routine terminal cleaning and disinfection (C/D) with bleach or 1 round of C/D followed by hydrogen peroxide vapor (HPV) treatment.

Setting.

A 900-bed tertiary care hospital.

Methods.

ABC and MRSA cultures were obtained from hospital rooms including 312 rooms (mean, 18.3 sites/room) following 4 rounds of C/D, 37 rooms (mean, 20 sites/room) following 1 round of C/D before and after HPV treatment, and 134 rooms (mean, 20 sites/room) following 1 round of C/D and HPV treatment.

Results.

Following 4 rounds of C/D, 83 (26.6%) rooms had 1 or more culture-positive sites; 102 (1.8%) sites in 51 (16.4%) rooms grew ABC, and 108 (1.9%) sites in 44 (14.1%) rooms grew MRSA. The addition of HPV treatment to 1 round of C/D resulted in a significant drop in ABC- and MRSA-positive room sites (odds ratio, 0 [95% confidence interval, 0–0.8]; P = .04 for both organisms). Following 1 round of C/D and HPV treatment, 6 (4.5%) rooms were culture-positive for ABC, MRSA, or both.

Conclusions.

Routine terminal C/D of hospital rooms vacated by MDRABC-positive patients may be associated with a significant number of ABC- or MRSA-positive room surfaces even when up to 4 rounds of C/D are performed. The addition of HPV treatment to 1 round of C/D appears effective in reducing the number of persistently contaminated room sites in this setting.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 32 , Issue 7 , July 2011 , pp. 667 - 672
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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References

1.Munoz-Price, LS, Weinstein, RA. Acinetobacter infection. N Engl J Med 2008;358:1271–1281.CrossRefGoogle ScholarPubMed
2.Vincent, JL, Rello, J, Marshall, J, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009;301:2323–2329.CrossRefGoogle Scholar
3.Beggs, CB, Kerr, KG, Snelling, AM, Sleigh, AM. Acinetobacter spp. and the clinical environment. Indoor Built Environ 2006;15:19–24.CrossRefGoogle Scholar
4.Simor, AE, Lee, M, Vearncombe, M, et al. An outbreak due to multiresistant Acinetobacter baumannii in a burn unit: risk factors for acquisition and management. Infect Control Hosp Epidemiol 2002;23:261–267.CrossRefGoogle Scholar
5.Dancer, SJ. The role of environment cleaning in the control of hospital-acquired infection. J Hosp Infect 2009;73:378–385.CrossRefGoogle ScholarPubMed
6.Playfod, EG, Craig, JC, Iredell, JR. Carbapenem-resistant Acinetobacter baumannii in intensive care unit patients: risk factors for acquisition, infection and their consequences. J Hosp Infect 2007;65:204–211.CrossRefGoogle Scholar
7.Tacconelli, E, Cataldo, MA, De Pascale, G, et al. Prediction models to identify hospitalized patients at risk of being colonized or infected with multidrug-resistant Acinetobacter baumannii calcoaceticus complex. J Antimicrob Chemother 2008;62:1130–1137.CrossRefGoogle ScholarPubMed
8.Tacconelli, E, De Angelis, G, Cataldo, MA, Pozzi, E, Cauda, R. Does antibiotic exposure increase the risk of methicillin-resistant Staphylococcus aureus (MRSA) isolation? a systematic review and meta-analysis. J Antimicrob Chemother 2008;61:26–38.CrossRefGoogle ScholarPubMed
9.Sunenshine, RH, Wright, M, Maragakis, LL, et al. Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis 2007;13:97–103.CrossRefGoogle ScholarPubMed
10.French, GL, Otter, JA, Shannon, KP, Adams, NM, Wading, D, Parks, MJ. Tackling contamination of the hospital environment by methiciilin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination. J Hosp Infect 2004;57:31–37.CrossRefGoogle Scholar
11.Corbella, X, Pujol, M, Argerich, MJ, et al. Environmental sampling of Acinetobacter baumannii: moistened swabs versus moistened sterile gauze pads. Infect Control Hosp Epidemiol 1999;20:458–460.CrossRefGoogle ScholarPubMed
12.Clinical and Laboratory Standards Institute (CLSI). 2007. Performance standards for antimicrobial susceptibility testing. Wayne, PA: CLSI, 2007:M100–S17.Google Scholar
13.Brown, DFJ, Edwards, DI, Hawkey, PM, et al. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). J Antimicrob Chemother 2005;56:1000–1018.CrossRefGoogle ScholarPubMed
14.Rutala, WA, Setzer, EB, Sherertz, RJ, Sarubbi, FA. Environmental study of a methicillin-resistant Staphylococcus aureus epidemic in a burn unit. J Clin Microbiol 1983;18:683–688.CrossRefGoogle Scholar
15.Zanetti, G, Blanc, DS, Federli, I, et al. Importation of Acinetobacter baumannii into a burn unit: a recurrent outbreak of infection associated with widespread environmental contamination. Infect Control Hosp Epidemiol 2007;28:723–725.CrossRefGoogle ScholarPubMed
16.Carling, PC, Parry, MF, VonBeheren, S, Kim, P, Woods, C, Healthcare Environmental Hygiene Group. Identifying opportunities to enhance environmental cleaning in 23 acute care hospitals. Infect Control Hosp Epidemiol 2008;29:1–7.CrossRefGoogle ScholarPubMed
17.Byers, KE, Durbin, LJ, Simonton, BM, Anglim, AM, Adal, KA, Farr, BM. Disinfection of hospital rooms contaminated with vancomycin-resistant Enterococcus faecium. Infect Control Hosp Epidemiol 1998;19:261–264.Google ScholarPubMed
18.Henwood, CJ, Gatward, T, Warner, M, et al. Antibiotic resistance among clinical isolates of Acinetobacter in the UK, and in vitro evaluation of tigecycline (GAR-936). J Antimicrob Chemother 2002;49:479–487.CrossRefGoogle ScholarPubMed