• Tieer Gan, Hong Xu, Jiannong Wu, Yuexian Zhu, Lanfang Wang, Hui Jin, Lingya Wei, Linhai Shen, Xiaoping Ni, Junmin Cao, and Ying Zhang.
• Department of Hospital Infection Control, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
• J Crit Care. 2017 Oct 1; 41: 216-221.

PurposeEffective cleaning of surfaces within hospital wards is necessary to reduce pathogen transmission. We investigated the roles of sequential enhanced cleaning by culturing pathogens from high-touch surfaces in a general intensive care unit.MethodsA before-after controlled study was conducted during a 17-month period in the 25-bed general intensive care unit. The study comprised a baseline period (period 1) and 4 sequential tiered interventions: each patient zone was wiped with a single clean microfiber cloth daily (period 2), fluorescent markers and adenosine triphosphate assay were used to monitor and provide feedback on the effectiveness of cleaning (period 3), wiping a single patient zone with 3 clean microfiber cloths daily (period 4), and withdrawal of the feedback (period 5).ResultsCompared with period 1, the cultures of multidrug-resistant organisms from high-touch surfaces were reduced by 41.0% (prevalence ratio [OR] = 0.59, P < .001), 70.8% (OR = 0.29, P < .001), 82.6% (OR = 0.17, P < .001), and 70.8% (OR = 0.29, P < .0001) in the subsequent sequential interventions, respectively.ConclusionAdoption of fluorescent markers and adenosine triphosphate bioluminescence reduced environmental contamination. Use of 3 cleaning cloths for 1 patient zone was more effective compared with a single cloth.Copyright © 2017 Elsevier Inc. All rights reserved.

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