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Standardized cleaning staff, protocol reduced C. difficile in hospital rooms
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A dedicated daily disinfection team and implementation of a standardized cleaning procedure significantly improved disinfection of hospital rooms for Clostridium difficile, according to a recent study.
“It is possible that there is an acceptable level of residual C. difficile spore contamination that presents a relatively low risk of transmission to subsequent room occupants,” Curtis Donskey, MD, staff physician at Louis Stokes Cleveland Veterans Affair Medical Center, and colleagues wrote. “However, given the low inoculum of spores required to produce disease in antibiotic-treated animals and the demonstration that spores on surfaces can easily be acquired on hands, the goal of our intervention was to achieve consistently negative cultures from hightouch surfaces after cleaning of [C. difficile-infected] rooms.”
To assess the of different interventions on the frequency of C. difficile environmental contamination in C. difficile-infected rooms cleaning and disinfection, Donkey and colleagues conducted a 21-month prospective study of three intervention sequences, including:
- Fluorescent markers applied to high-touch surfaces in rooms to provide supervision and feedback on diligence of cleaning;
- Automated ultraviolet radiation device as a complementary disinfection approach used after cleaning;
- Enhanced disinfection method consisting of a dedicated daily disinfection team and a procedure requiring managerial assessment and clearance of C. difficile infected rooms.
each intervention sequence of cleaning and disinfection, the researchers obtained cultures rooms contaminated with C. difficile.
Study results demonstrated that the fluorescent marker intervention moderately improved the disinfection of high-touch surfaces over traditional cleaning practices (from 47% to 81% marker removal; P<.0001).
Compared the baseline period, the prevalence of positive cultures from C. difficile-infected rooms was reduced by 14% (P=.024) the fluorescent marker intervention, 48% (P<.001) after the automated UV radiation intervention and 89% (P=.006) cleaning by a dedicated daily disinfection team.
“The adjunctive use of an automated UV device improved disinfection, but 35% of rooms remained culture positive for C. difficile after use of the devices,” Donkey and colleagues wrote. “Ultimately, disinfection was dramatically improved through formation of a dedicated daily disinfection team and implementation of a standardized process for clearing [C. difficile-infected] rooms. Our experience suggests that culturing of [C. difficile-infected] rooms after terminal cleaning could provide a valuable means to assess the effectiveness of cleaning interventions.”
Disclosure: The researchers reported no relevant financial disclosures.
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