A reoccurring theme discussed throughout the Society for Healthcare Epidemiology of America (SHEA) Spring 2017 Conference was finding ways to prevent the transmission of healthcare-associated infections in healthcare facilities. On March, 30, 2017, David P. Calfee, MD, MS, associate professor of Medicine and Health Policy & Research, Weill Cornell Medicine, talked about the role that the environment plays in transmission, and why cleaning and disinfection measures need to be improved to reduce these infections.
The hospital environment frequently harbors a variety of pathogens. For example, investigators have shown that 42% of rooms holding patients with Acinetobacter baumannii
infection were contaminated with that organism, and in methicillin-resistant Staphylococcus aureus
(MRSA) patient rooms, that number rises to 73%. Even more unsettling is that some investigators have reported 100% environmental contamination of rooms housing patients with Clostridium difficile
“Now you might say, of course, that’s not a surprise, but it might not be that important because these rooms are being cleaned on a daily basis, and again, even more thoroughly at the time of discharge. However, a lot of evidence is out there that suggests these pathogens are frequently recoverable from the environment after cleaning has occurred,” Dr. Calfee said.
To this end, Dr. Calfee cited a recent three-year long study of nine hospitals and two long-term health facilities that found that even after daily cleaning was performed in “multidrug-resistant organism (MDRO) contact isolation rooms,” in 34% of the rooms, MDROs were recoverable from the environment. Even more unsettling is that, even after terminal or discharge cleaning, which is arguably more laborious, investigators were still
able to recover MDROs in 18% of the rooms.
So, why aren’t current cleaning and disinfection practices getting rid of these harmful pathogens?
Dr. Calfee postulates, “I think a very simple and probably basic explanation for all of this is that these services just aren’t being cleaned reliably.”