Highlights
- •All surfaces were contaminated with crAssphage or high levels of organic debris
- •Without a recent outbreak, noroviruses were not found on the LTC facility surfaces
- •The highest levels of ATP and/or crAssphage were in patient rooms and public areas.
- •Hygienic monitoring identified where cleaning efforts could be heightened
- •Information is helpful in guiding infection control procedures in LTC facilities
Abstract
Background
Norovirus and C. difficile are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities
and can be transmitted by contaminated environmental surfaces. Hygienic monitoring
tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal
contamination can help to identify LTC facility surfaces with cleaning deficiencies.
Methods
High-touch surfaces in 11 LTC facilities were swabbed and tested for contamination
by norovirus, a fecal indicator virus, crAssphage, and ATP which detects organic debris.
High levels of contamination were defined as log ATP relative light unit values or
crAssphage log genomic copy values in the 75th percentile of values obtained from
each facility.
Results
Over 90% of surfaces tested positive for crAssphage or gave failing ATP scores. Norovirus
contamination was not detected. Handrails, equipment controls, and patient beds were
4 times more likely than other surfaces or locations to have high levels of crAssphage.
Patient bed handrails and tables and chairs in patient lounges had high levels of
both ATP and crAssphage.
Conclusions
Surfaces with high levels of ATP and crAssphage were identified. Quantifying levels
of contamination longitudinally and before and after cleaning might enhance infection
prevention and control procedures for reducing diarrheal illnesses in LTC facilities.
Key Words
Abbreviations:
C. difficile (Clostridioides difficile), CDI (C. difficile infection), LTC (long-term care), ATP (adenosine triphosphate), PCR (polymerase chain reaction), RT-PCR (reverse transcriptase PCR)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 23, 2022
Footnotes
Funding/support: Research on hygienic monitoring in LTC facilities was funded in part by Agriculture and Food Research Initiative competitive grant 2011-68003-30395 from the USDA National Institute of Food and Agriculture and grant 5R01HS025987-03 and Agency for Healthcare Research and Quality competitive grant R01 HS025987 from the National Institutes of Health.
The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Conflicts of interest: None to report.
Identification
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© 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
