Background
Environmental contamination is a reservoir for vancomycin-resistant enterococcus (VRE)
in hospitals.
Methods
Environmental sampling of surfaces was undertaken anytime before disinfection and
1 hour after disinfection utilizing a sodium dichloroisocyanurate-based, 3-staged
protocol (phase 1) or benzalkonium chloride-based, single-stage clean (phase 2). VRE
colonization and infection rates are presented from 2010 to 2011, and audits of cleaning
completeness were also analyzed.
Results
Environmental samples collected before disinfection were significantly more likely
to be contaminated with VRE during phase 1 than phase 2: 25.2% versus 4.6%, respectively;
odds ratio (OR), 7.01 (P < .01). Environmental samples collected after disinfection were also significantly
more likely to yield VRE during phase 1 compared with phase 2: 11.2% versus 1.1%,
respectively; OR, 11.73 (P < .01). Rates of VRE colonization were higher during 2010 than 2011. Cleaning audits
showed similar results over both time periods.
Conclusion
During use of a chlorine-based, 3-staged protocol, significantly higher residual levels
of VRE contamination were identified, compared with levels detected during use of
a benzalkonium chloride-based product for disinfection. This reduction in VRE may
be due to a new disinfection product, more attention to the thoroughness of cleaning,
or other supplementary efforts in our institution.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Infection ControlAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Eradication of a large outbreak of a single strain of vanB vancomycin-resistant Enterococcus faecium at a major Australian teaching hospital.Infect Control Hosp Epidemiol. 2004; 25: 384-390
- Role of environmental contamination in the transmission of vancomycin-resistant enterococci.Infect Control Hosp Epidemiol. 1997; 18: 306-309
- Persistent contamination of fabric-covered furniture by vancomycin-resistant enterococci: implications for upholstery selection in hospitals.Am J Infect Control. 2000; 28: 311-313
- Survival of vancomycin-resistant enterococci on dry surfaces.J Clin Microbiol. 1998; 36: 3734-3736
- Environmental contamination makes an important contribution to hospital infection. Proceedings of the Sixth International Conference of the Hospital Infection Society.J Hosp Infect. 2007; 65: 50-54
- Impact of an environmental cleaning intervention on the presence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci on surfaces in intensive care unit rooms.Infect Control Hosp Epidemiol. 2008; 29: 593-599
- Controlling vancomycin-resistant enterococci.Infect Control Hosp Epidemiol. 1995; 16: 634-637
Montecalvo MA, Shay D, Andryshack. Efficacy of enhanced infection control measures to reduce transmission of vancomycin-resistant enterococci. Abstract J39. In Program and Abstracts of the 35th Interscience Conference on Antimicrobial Therapy and Chemotherapy. American Society for Microbiology, Washington (DC); 1995.
- Chlorine and chlorine compounds.in: Block S.S. Disinfection, sterilization, and preservation. 4th ed. Lea & Febiger, Philadelphia (PA)1991: 131-151
Australian guidelines for the prevention and control of infection in healthcare. 2010. Available from: http://www.nhmrc.gov.au/node/30290. Accessed October 20, 2011.
- Duck hepatitis B virus: a model to assess efficacy of disinfectants against hepadnavirus infectivity.Epidemiol Infect. 1991; 106: 435-443
- Reduction in acquisition of Vancomycin-resistantenterococcus after enforcement of routine environmental cleaning measures.Clin Infect Dis. 2006; 42: 1552-1560
- Symposium on methods for determining bacterial contamination on surfaces.Bacteriol Rev. 1955; 19: 284-287
Ledeboer N, Dunne M. 2006. Evaluation of a novel chromogenic agar medium from bioMérieux to screen for vancomycin-resistant Enterococcus faecium and E faecalis. Program and Abstracts of 46th Interscience Conference on Antimicrobial Therapy and Chemotherapy. American Society for Microbiology, San Francisco, CA; 2006.
Statewide Quality Branch, Rural and Regional Health and Aged Care Services, Department of Human Services, Melbourne, Victoria. Cleaning standards for Victorian health facilities 2009. Copyright State of Victoria 2008. Available from: http://www.health.vic.gov.au/infection prevention/downloads/cleaning-standards-2009.pdf. Accessed November 1, 2011.
- Environmental cleaning intervention and risk of acquiring multi-resistant organisms from prior room occupants.Arch Intern Med. 2011; 171: 491-494
- Interventional evaluation of environmental contamination by vancomycin-resistant enterococci: failure of personnel, product, or procedure?.J Hosp Infect. 2009; 71: 123-131
- Improving cleaning of the environment surrounding patients in 36 acute care hospitals.Infect Control Hosp Epidemiol. 2008; 29 (Available from:) (Accessed October 20, 2011): 1035-1041
- Uses of inorganic hypochlorite (bleach) in health-care facilities.Clin Micro Rev. 1997; 10: 597-610
- Chemical germicides use in the United States: 1994 and Beyond.in: Rutala W.A. Chemical Germicides in Health Care. Polyscience Publications, Quebec, Canada1995: 1-22
- Activity of disinfectants against vancomycin-resistant Enteroccoccus faecium.Infect Control Hosp Epidemiol. 1997; 18: 345-347
Article info
Publication history
Published online: September 14, 2012
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
