Pathogens Linger Despite Terminal Room Cleaning and Disinfection

Farrin A. Manian, MD, MPH, of the Division of Infectious Diseases and the Department of Infection Control at St. Johns Mercy Medical Center in St. Louis, and colleagues, sought 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 one round of C/D followed by hydrogen peroxide vapor (HPV) treatment.

In the study conducted in a 900-bed tertiary care hospital, the researchers obtained ABC and MRSA cultures from hospital rooms including 312 rooms after following four rounds of C/D, 37 rooms after one round of C/D before and after HPV treatment, and 134 rooms after one round of C/D and HPV treatment.

The researchers report that after four rounds of C/D, 83 (26.6 percent) rooms had one or more culture-positive sites; 102 (1.8 percent) sites in 51 (16.4 percent) rooms grew ABC, and 108 (1.9 percent) sites in 44 (14.1 percent) rooms grew MRSA. They report that the addition of HPV treatment to one round of C/D resulted in a significant drop in ABC- and MRSA-positive room sites for both organisms. Following one round of C/D and HPV treatment, six (4.5 percent) rooms were culture-positive for ABC, MRSA, or both.

Manian, et al. concluded that routine terminal cleaning and disinfection 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 four rounds of C/D are performed. The researchers also say that the addition of HPV treatment to one round of C/D appears effective in reducing the number of persistently contaminated room sites in this setting.

Reference: Manian FA, et al. Isolation of Acinetobacter baumannii Complex and Methicillin-Resistant Staphylococcus aureus from Hospital Rooms Following Terminal Cleaning and Disinfection: Can We Do Better? Infect Control Hosp Epidem. Vol. 32, No. 7. Pp. 667-672. July 2011.