}

Hospital cleaning protocol ineffective against A. Baumannii

11/30/2012

Current hospital cleaning protocol may be inadequate to rid patient rooms of multidrug-resistant (MDR) Acinetobacter baumannii, according to a study in the December issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

A team of researchers from the University of Maryland collected 487 cultures from 32 hospital rooms occupied by just-discharged patients with a known history of MDR A. baumannii both before and after terminal cleaning of the rooms. Over half of the rooms positive for the A. baumannii bacteria prior to cleaning remained contaminated after terminal cleaning had occurred.

Fifteen rooms (46.9 percent) and 41 sites (n=268, 15.3 percent) tested positive for MDR A. baumannii before cleaning. Post-cleaning, eight rooms (25 percent) and 12 sites (n=219, 5.5 percent) still tested positive for the pathogen. Sites with post-cleaning contamination included the floor (12.5 percent), call button (10 percent), door handle (9.4 percent) bedside table (7.4 percent), and supply cart (3.8 percent).

“Persistent room contamination serves as a potential reservoir for transmission and colonization of future room occupants,” state the authors in the article. “Current cleaning techniques in terms of products used or thoroughness of cleaning may not be adequate in the decontamination of this pathogen.”

Acinetobacter baumannii is a type of bacteria that has become increasingly prevalent in healthcare facilities and is resistant to most antibiotics. Infections from this pathogen primarily occur in very ill, wounded, or immunocompromised patients. The germ can remain on wet or dry surfaces for longer than most other organisms, making it harder to eradicate. 

"This study shows how difficult it is to ensure removal of particularly resistant organisms from the environment even upon thorough discharge cleaning," said Anthony D. Harris, MD, MPH, lead study author and professor of epidemiology and public health at the University of Maryland School of Medicine. "With new, innovative means of monitoring cleaning processes that we have incorporated since the study was done, coupled with other infection control efforts, we are seeing lower rates of A. baumannii at our hospital."  

Full text of the article is available to journalists upon request; contact Liz Garman, APIC, 202-454-2604, egarman@apic.org to obtain copies.

ABOUT AJIC: AMERICAN JOURNAL OF INFECTION CONTROL
AJIC: American Journal of Infection Control (www.ajicjournal.org) covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL.

ABOUT APIC
APIC’s mission is to create a safer world through prevention of infection. The association’s more than 14,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at www.apic.org. Follow APIC on Twitter: http://twitter.com/apic.  

NOTES FOR EDITORS
“The effect of terminal cleaning on environmental contamination rates of multidrug-resistant Acinetobacter Baumannii” by Paula Strassle, Kerri A. Thom, J. Kristie Johnson, Surbhi Leekha, Matthew Lissauer, Jingkun Zhu and Anthony D. Harris appears in the American Journal of Infection Control, Volume 40, Issue 10 (December 2012).

Authors:

Paula Strassle, BS
Department of Epidemiology and Public Health, University of Maryland
Baltimore School of Medicine, Baltimore, MD

Kerri A. Thom, MD
Department of Epidemiology and Public Health, University of Maryland
Baltimore School of Medicine, Baltimore, MD

J. Kristie Johnson, PhD (ABMM)
Department of Pathology, University of Maryland, Baltimore School of Medicine
Baltimore, MD

Surbhi Leekha, MBBS, MPH
Department of Epidemiology and Public Health, University of Maryland
Baltimore, MD

Matthew Lissauer, MD, FACS
University of Maryland, Baltimore School of Medicine, Program in Trauma
R. Adams Cowley Shock Trauma Center, Baltimore, MD

Jingkun Zu, MS
Department of Epidemiology and Public Health, University of Maryland
Baltimore School of Medicine, Baltimore, MD

Anthony D. Harris, MD, MPH (Corresponding Author)
Department of Epidemiology and Public Health, University of Maryland
Baltimore School of Medicine, Baltimore, MD


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Contact Info

Liz Garman

202-454-2604
egarman@apic.org