Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · May 2013
Randomized Controlled TrialA randomized controlled trial of enhanced cleaning to reduce contamination of healthcare worker gowns and gloves with multidrug-resistant bacteria.
OBJECTIVE. To determine whether enhanced daily cleaning would reduce contamination of healthcare worker (HCW) gowns and gloves with methicillin-resistant Staphylococcus aureus (MRSA) or multidrug-resistant Acinetobacter baumannii (MDRAB). DESIGN. A cluster-randomized controlled trial. SETTING. Four intensive care units (ICUs) in an urban tertiary care hospital. ⋯ For MRSA, the mean proportions were 22% and 19%, respectively (relative risk, 0.89 [95% confidence interval, 0.50-1.53]; P = .16). DISCUSSION. Intense enhanced daily cleaning of ICU rooms occupied by patients colonized with MRSA or MDRAB was associated with a nonsignificant reduction in contamination of HCW gowns and gloves after routine patient care activities. Further research is needed to determine whether intense environmental cleaning will lead to significant reductions and fewer infections.
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Infect Control Hosp Epidemiol · May 2013
Risk of acquiring extended-spectrum β-lactamase-producing Klebsiella species and Escherichia coli from prior room occupants in the intensive care unit.
OBJECTIVE. To quantify the association between admission to an intensive care unit (ICU) room most recently occupied by a patient positive for extended-spectrum β-lactamase (EBSL)-producing gram-negative bacteria and acquisition of infection or colonization with that pathogen. DESIGN. Retrospective cohort study. SETTING AND PATIENTS. The study included patients admitted to medical and surgical ICUs of an academic medical center between September 1, 2001, and June 30, 2009. ⋯ PFGE results suggested that 6 (18%) of 32 patients acquired a bacterial strain that was the same as or closely related to the strain obtained from the prior occupant. CONCLUSIONs. These data suggest that environmental contamination may not play a substantial role in the transmission of ESBL-producing pathogens among ICU patients. Intensifying environmental decontamination may be less effective than other interventions in preventing transmission of ESBL-producing pathogens.
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Infect Control Hosp Epidemiol · May 2013
Saving costs through the decontamination of the packaging of unused medical supplies using hydrogen peroxide vapor.
OBJECTIVE. Individually packaged sterile supply items may become contaminated and act as vectors for nosocomial transmission of multidrug-resistant organisms (MDROs). Thus, many hospitals have a policy to dispose of these unused, packaged supply items at patient discharge from the hospital, which has considerable cost implications. We evaluated the frequency of contamination of these items, the efficacy of hydrogen peroxide vapor (HPV) in disinfecting them, and costs associated with discarded supplies. ⋯ The annual cost of supplies discarded at patient hospital discharge was $387,055. This figure does not include the cost of waste disposal and is therefore likely to be an underestimation of the financial burden. CONCLUSIONS. HPV effectively disinfected the packaging of supply items, which could generate considerable financial and environmental benefits.
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Infect Control Hosp Epidemiol · May 2013
Rapid hospital room decontamination using ultraviolet (UV) light with a nanostructured UV-reflective wall coating.
We tested the ability of an ultraviolet C (UV-C)-reflective wall coating to reduce the time necessary to decontaminate a room using a UV-C-emitting device (Tru-D SmartUVC). The reflective wall coating provided the following time reductions for decontamination: for methicillin-resistant Staphylococcus aureus, from 25 minutes 13 seconds to 5 minutes 3 seconds ([Formula: see text]), and for Clostridium difficile spores, from 43 minutes 42 seconds to 9 minutes 24 seconds ([Formula: see text]).