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
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
- Management of multidrug-resistant organisms in health care settings.Am J Infect Control. 2007; 35: S165-S193
- Best practice in healthcare environment decontamination.Eur J Clin Microbiol Infect Dis. 2015; 34: 1-11
- Hospital cost of Clostridium difficile infection including the contribution of recurrences in French acute-care hospitals.J Hosp Infect. 2015; 91: 117-122
- The role played by contaminated surfaces in the transmission of nosocomial pathogens.Infect Control Hosp Epidemiol. 2011; 32: 687-699
- Role of the environment in the transmission of Clostridium difficile in health care facilities.Am J Infect Control. 2013; 41: S105-S110
- Role of hospital surfaces in the transmission of emerging health care-associated pathogens: Norovirus, Clostridium difficile, and Acinetobacter species.Am J Infect Control. 2010; 38: S25-S33
- Daily disinfection of high-touch surfaces in isolation rooms to reduce contamination of healthcare workers' hands.Infect Control Hosp Epidemiol. 2012; 33: 1039-1042
- Acquisition of spores on gloved hands after contact with the skin of patients with Clostridium difficile infection and with environmental surfaces in their rooms.Am J Infect Control. 2012; 40: 556-558
- A Study of the relationship between environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and patients' acquisition of MRSA.Infect Control Hosp Epidemiol. 2006; 27: 127-132
- Risk of acquiring antibiotic-resistant bacteria from prior room occupants.Arch Intern Med. 2006; 166: 1945-1951
- Risk of acquiring multidrug-resistant Gram-negative bacilli from prior room occupants in the intensive care unit.Clin Microbiol Infect. 2011; 17: 1201-1208
- Evaluation of hospital room assignment and acquisition of Clostridium difficile infection.Infect Control Hosp Epidemiol. 2011; 32: 201-206
- The crucial role of wiping in decontamination of high-touch environmental surfaces: review of current status and directions for the future.Am J Infect Control. 2013; 41: S97-104
- The development of a new three-step protocol to determine the efficacy of disinfectant wipes on surfaces contaminated with Staphylococcus aureus.J Hosp Infect. 2007; 67: 329-335
- Limitations of the efficacy of surface disinfection in the healthcare settings.Infect Control Hosp Epidemiol. 2009; 30: 570-573
- Efficacy of “sporicidal” wipes against Clostridium difficile.Am J Infect Control. 2011; 39: 212-218
- Pathogen transfer and high variability in pathogen removal by detergent wipes.Am J Infect Control. 2015; 43: 724-728
- Transfer of Clostridium difficile spores by non-sporicidal wipes and improperly used hypochlorite wipes: practice + product = perfection.Infect Control Hosp Epidemiol. 2013; 34: 441-442
- Disinfectant wipes are appropriate to control microbial bioburden from surfaces: use of a new ASTM standard test protocol to demonstrate efficacy.J Hosp Infect. 2015; 91: 319-325
- Evaluation of a new hydrogen peroxide wipe disinfectant.Infect Control Hosp Epidemiol. 2013; 34: 521-523
- Tackling C. difficile with environmental cleaning.Nurs Times. 2010; 107: 22-25
- A targeted strategy to wipe out Clostridium difficile.Infect Control Hosp Epidemiol. 2011; 32: 1137-1139
- Prospective cluster controlled crossover trial to compare the impact of an improved hydrogen peroxide disinfectant and a quaternary ammonium–based disinfectant on surface contamination and healthcare outcomes.Am J Infect Control. 2017; 45: 1006-1010
- Prevalence of Clostridium difficile environmental contamination and strain variability in multiple health care facilities.Am J Infect Control. 2007; 35: 315-318
- Rapid detection, differentiation and typing of methicillin-resistant Staphylococcus aureus harbouring either mecA or the new mecA homologue mecALGA251.Clin Microbiol Infect. 2012; 18: 395-400
- Identification of methicillin-resistant strains of staphylococci by polymerase chain reaction.J Clin Microbiol. 1991; 29: 2240-2244
- Typing of Staphylococcus aureus clinical isolates using random amplification of polymorphic DNA method and comparison to antibiotic susceptibility typing.J Hosp Infect. 2007; 67: 388-390
- Finding a benchmark for monitoring hospital cleanliness.J Hosp Infect. 2011; 77: 25-30
- A modified ATP benchmark for evaluating the cleaning of some hospital environmental surfaces.J Hosp Infect. 2008; 69: 156-163
- Are hygiene standards useful in, assessing infection risk?.Am J Infect Control. 2008; 36: 381-384
- A multicenter randomized trial to determine the effect of an environmental disinfection intervention on the incidence of healthcare-associated Clostridium difficile infection.Infect Control Hosp Epidemiol. 2017; 38: 777-783
- Maintain the gain: program to sustain performance improvement in environmental cleaning.Infect Control Hosp Epidemiol. 2014; 35: 866-868
- A modified ATP benchmark for evaluating the cleaning of some hospital environmental surfaces.J Hosp Infect. 2008; 69: 156-163
- Monitoring the effectiveness of hospital cleaning practices using an ATP bioluminescence assay.Infect Control Hosp Epidemiol. 2009; 30: 678-684
- Usage of antimicrobial biocides and products in the healthcare environment: efficacy, policies, management and perceived problems.Ther Clin Risk Manag. 2005; 1: 307-320
- Does microbiocide use in consumer products promote antimicrobial resistance? A critical review and recommendations for a cohesive approach to risk assessment.Microb Drug Resist. 2013; 19: 344-354
Article info
Publication history
Published online: May 11, 2018
Footnotes
Supported by Innovate UK as part of a Knowledge Transfer Partnership (agreement No. KTP008770) between Cardiff University and GAMA Healthcare Ltd.
Conflicts of interest: None to report.
Identification
Copyright
© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
