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Impact of antimicrobial wipes compared with hypochlorite solution on environmental surface contamination in a health care setting: A double-crossover study

      Highlights

      • This double crossover study is the first controlled field trial comparison between the use of pre-wetted wipes and cloth material dipped into a bucket of hypochlorite to decrease surface microbial bioburden.
      • 1566 environmental samples and 1591 ATP swabs were samples from 11 sites over a 29 weeks period.
      • The use of pre-wetted wipes produced the largest reduction in the total aerobic and anaerobic counts when compared to the use of 1,000 ppm chlorine.
      • Collectively the introduction of training plus daily wipe disinfection significantly reduced multidrug resistant organisms recovered from surfaces.
      • The practice of using hypochlorite diluted solution in a bucket in combination with some cloth materials might need revision.

      Objective

      Antimicrobial wipes are increasingly used in health care settings. This study evaluates, in a clinical setting, the efficacy of sporicidal wipes versus a cloth soaked in a 1,000 ppm chlorine solution.

      Intervention

      A double-crossover study was performed on 2 different surgical and cardiovascular wards in a 1,000-bed teaching hospital over 29 weeks. The intervention period that consisted of surface decontamination with the preimpregnated wipe or cloth soaked in chlorine followed a 5-week baseline assessment of microbial bioburden on surfaces. Environmental samples from 11 surfaces were analyzed weekly for their microbial content.

      Results

      A total of 1,566 environmental samples and 1,591 ATP swabs were analyzed during the trial. Overall, there were significant differences in the recovery of total aerobic bacteria (P < .001), total anaerobic bacteria (P < .001), and ATP measurement (P < .001) between wards and between the different parts of the crossover study. Generally, the use of wipes produced the largest reduction in the total aerobic and anaerobic counts when compared with the baseline data or the use of 1,000 ppm chlorine. Collectively, the introduction of training plus daily wipe disinfection significantly reduced multidrug-resistant organisms recovered from surfaces. Reversion to using 1,000 ppm chlorine resulted in the number of sites positive for multidrug-resistant organisms rising again.

      Conclusions

      This double-crossover study is the first controlled field trial comparison of using preimpregnated wipes versus cotton cloth dipped into a bucket of hypochlorite to decrease surface microbial bioburden. The results demonstrate the superiority of the preimpregnated wipes in significantly decreasing microbial bioburden from high-touch surfaces.

      Key Words

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