The good news is that an increasing number of hospitals are becoming aware of the role that contaminated environmental surfaces play in the transmission of pathogenic organisms. The bad news is that many hospitals still are not doing everything they can to ensure rigorous environmental cleaning protocols and practices, hence the continued proliferation of multidrug-resistant organisms (MDROs) and infections that can trigger increased healthcare costs, lengths of stay and mortality. It’s certainly not for a lack of data on the subject; Goodman (2008) observes, “Environmental contamination with pathogens commonly occurs during routine medical care. Many studies have described transmission of pathogenic organisms through contact with contaminated room surfaces.” And Eckstein (2007) notes, “Patients colonized or infected with healthcare-associated pathogens often shed these organisms onto their skin and into the environment. Although direct contact with patients is generally considered the major source for acquisition of pathogens on healthcare workers’ hands and subsequent transmission to other patients, several recent studies suggest that contaminated environmental surfaces may also play an important role in pathogen transmission.”
Goodman (2008) found that vancomycin-resistant Enterococci (VRE) and Staphylococcus aureus were frequently acquired on hands after contact with contaminated objects such as bed rails and bedside tables in colonized patients’ rooms. However, they also found that daily disinfection of environmental surfaces in VRE-colonized patients’ rooms was associated with reduced acquisition of this pathogen on hands. Studies have demonstrated that routine environmental cleaning can decrease VRE contamination on surfaces and healthcare workers’ hands, and also control VRE cross-transmission. Other studies indicate that a reduction in Clostridium difficile infection can be achieved through environmental decontamination.
It’s a message that hasn’t been lost on Phillip C. Carling, MD, director of infectious diseases and epidemiology at Caritas Carney Hospital in Boston and a professor at Boston University School of Medicine. Carling has long been an advocate of pairing the basics of infection prevention such as handwashing, with environmental cleaning and better education of environmental services (ES) personnel to cultivate greater awareness of sanitation technique.
