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In 2010 I pioneered Australia’s first study showing that efficiency of routine cleaning was on average about 50% meaning that half of the time hospital rooms were not cleaned properly. This was an alarming fact but identical to results from the USA and other countries who had studied the problem. Great new technologies have been developed which US and UK research proves can eliminate any bugs that remain in improperly cleaned rooms. However their cost and a general reluctance to adopt them or include them as an option is limiting their adoption and use in Australia. Today the article below from the US CDC has been published showing that in a long study of several US hospitals serious multiple drug resistant organisms (MDROs) {Superbugs} were recovered from 34% of routine cleaned room composites (range 1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms. This is a very important finding and it should compel Australian policy makers to immediately relook at ways to support the use of those “waterless” systems of high level room disinfection such as pulsed Xenon, peracetic gas or ultraviolet light options. We can control antibiotic use as much as we like but if we can’t improve basics like hand hygiene compliance and staff healthcare organisations with enough, well-trained and well-supported cleaning staff we have no chance of providing staff with rooms clean enough to protect patients from being a risk of develop a serious hospital infection. Obviously I appreciate the cost and effort required to implement new methods and technologies as well as current Australian research looking at bundled approaches (hand hygiene and traditional manual cleaning – both of which are likely ineffective in their current practice) but we really can no longer bury our heads about this issue and we need to give it priority.
________________________________
Infect Control Hosp Epidemiol. 2016 Sep 13:1-7. [Epub ahead of print]
Assessment of the Overall and Multidrug-Resistant Organism Bioburden on Environmental Surfaces in Healthcare Facilities.
Shams AM1, Rose LJ1, Edwards JR1, Cali S2, Harris AD3, Jacob JT4, LaFae A4, Pineles LL3, Thom KA3, McDonald LC1, Arduino MJ1, Noble-Wang JA1.
Author information* 11Division of Healthcare Quality Promotion,National Center for Emerging and Zoonotic Infectious Diseases,Centers for Disease Control and Prevention,Atlanta,Georgia.
* 22University of Illinois at Chicago School of Public Health,Chicago,Illinois.
* 33University of Maryland School of Medicine,Baltimore,Maryland.
* 44Emory University School of Medicine,Atlanta,Georgia.
Abstract
OBJECTIVE To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning. DESIGN Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2). SETTING MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states. PARTICIPANTS Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms). METHODS Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room. Composite 1 included the TV remote, telephone, call button, and bed rails. Composite 2 included the room door handle, IV pole, and overbed table. Composite 3 included toileting surfaces. Total bacteria and MDROs (ie, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci [VRE], Acinetobacter baumannii, Klebsiella pneumoniae, and C. difficile) were quantified, confirmed, and tested for drug resistance. RESULTS The mean microbial bioburden and range from routine cleaned room composites were higher (2,700 colony-forming units [CFU]/100 cm2; 1-130,000 CFU/100 cm2) than from terminal cleaned room composites (353 CFU/100 cm2; 1-4,300 CFU/100 cm2). MDROs were recovered from 34% of routine cleaned room composites (range 1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms; VRE was the most common (19%). CONCLUSIONS This multicenter bioburden summary provides a first step to determining microbial bioburden on healthcare surfaces, which may help provide a basis for developing standards to evaluate cleaning and disinfection as well as a framework for studies using an evidentiary hierarchy for environmental infection control. Infect Control Hosp Epidemiol 2016;1-7.
Warm regards
CathCathryn Murphy MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4220
OLD, AustraliaE: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W: infectioncontrolplus.com.auMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi Cath
Yes, cleaning effectiveness in hospitals is definitely a concern. There is a current QUT research study on how to improve cleaning effectiveness with a bundle approach without additional expensive technology, which (if demonstrated to be effective) may be an option for hospitals to adopt at a lesser cost than some of the newer technologies. Worth watching this study, I think.
It may be that a combination of this type of cleaning bundle and some newer technologies (like vapourised hydrogen peroxide) for some specific indications may be the most cost effective and efficient process.
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this emailIn 2010 I pioneered Australia’s first study showing that efficiency of routine cleaning was on average about 50% meaning that half of the time hospital rooms were not cleaned properly. This was an alarming fact but identical to results from the USA and other countries who had studied the problem. Great new technologies have been developed which US and UK research proves can eliminate any bugs that remain in improperly cleaned rooms. However their cost and a general reluctance to adopt them or include them as an option is limiting their adoption and use in Australia. Today the article below from the US CDC has been published showing that in a long study of several US hospitals serious multiple drug resistant organisms (MDROs) {Superbugs} were recovered from 34% of routine cleaned room composites (range 1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms. This is a very important finding and it should compel Australian policy makers to immediately relook at ways to support the use of those “waterless” systems of high level room disinfection such as pulsed Xenon, peracetic gas or ultraviolet light options. We can control antibiotic use as much as we like but if we can’t improve basics like hand hygiene compliance and staff healthcare organisations with enough, well-trained and well-supported cleaning staff we have no chance of providing staff with rooms clean enough to protect patients from being a risk of develop a serious hospital infection. Obviously I appreciate the cost and effort required to implement new methods and technologies as well as current Australian research looking at bundled approaches (hand hygiene and traditional manual cleaning – both of which are likely ineffective in their current practice) but we really can no longer bury our heads about this issue and we need to give it priority.
________________________________
Infect Control Hosp Epidemiol. 2016 Sep 13:1-7. [Epub ahead of print]
Assessment of the Overall and Multidrug-Resistant Organism Bioburden on Environmental Surfaces in Healthcare Facilities.
Shams AM1, Rose LJ1, Edwards JR1, Cali S2, Harris AD3, Jacob JT4, LaFae A4, Pineles LL3, Thom KA3, McDonald LC1, Arduino MJ1, Noble-Wang JA1.
Author information* 11Division of Healthcare Quality Promotion,National Center for Emerging and Zoonotic Infectious Diseases,Centers for Disease Control and Prevention,Atlanta,Georgia.
* 22University of Illinois at Chicago School of Public Health,Chicago,Illinois.
* 33University of Maryland School of Medicine,Baltimore,Maryland.
* 44Emory University School of Medicine,Atlanta,Georgia.
Abstract
OBJECTIVE To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning. DESIGN Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2). SETTING MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states. PARTICIPANTS Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms). METHODS Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room. Composite 1 included the TV remote, telephone, call button, and bed rails. Composite 2 included the room door handle, IV pole, and overbed table. Composite 3 included toileting surfaces. Total bacteria and MDROs (ie, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci [VRE], Acinetobacter baumannii, Klebsiella pneumoniae, and C. difficile) were quantified, confirmed, and tested for drug resistance. RESULTS The mean microbial bioburden and range from routine cleaned room composites were higher (2,700 colony-forming units [CFU]/100 cm2; 1-130,000 CFU/100 cm2) than from terminal cleaned room composites (353 CFU/100 cm2; 1-4,300 CFU/100 cm2). MDROs were recovered from 34% of routine cleaned room composites (range 1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms; VRE was the most common (19%). CONCLUSIONS This multicenter bioburden summary provides a first step to determining microbial bioburden on healthcare surfaces, which may help provide a basis for developing standards to evaluate cleaning and disinfection as well as a framework for studies using an evidentiary hierarchy for environmental infection control. Infect Control Hosp Epidemiol 2016;1-7.
Warm regards
CathCathryn Murphy MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4220
OLD, AustraliaE: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W: infectioncontrolplus.com.au______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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Yes SAWMH is apart of this study so should be interesting to see what comes out of it.
With kind regards,
Lynette CribbInfection Control Coordinator
Direct 07 3834 4328 | mobile 0427141223 | Fax 0738344599
SAWMH.ICC@uchealth.com.au | standrewshospital.com.au
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[Description: 5 moments hand hygiene]Hi Cath
Yes, cleaning effectiveness in hospitals is definitely a concern. There is a current QUT research study on how to improve cleaning effectiveness with a bundle approach without additional expensive technology, which (if demonstrated to be effective) may be an option for hospitals to adopt at a lesser cost than some of the newer technologies. Worth watching this study, I think.
It may be that a combination of this type of cleaning bundle and some newer technologies (like vapourised hydrogen peroxide) for some specific indications may be the most cost effective and efficient process.
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this emailIn 2010 I pioneered Australia’s first study showing that efficiency of routine cleaning was on average about 50% meaning that half of the time hospital rooms were not cleaned properly. This was an alarming fact but identical to results from the USA and other countries who had studied the problem. Great new technologies have been developed which US and UK research proves can eliminate any bugs that remain in improperly cleaned rooms. However their cost and a general reluctance to adopt them or include them as an option is limiting their adoption and use in Australia. Today the article below from the US CDC has been published showing that in a long study of several US hospitals serious multiple drug resistant organisms (MDROs) {Superbugs} were recovered from 34% of routine cleaned room composites (range 1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms. This is a very important finding and it should compel Australian policy makers to immediately relook at ways to support the use of those “waterless” systems of high level room disinfection such as pulsed Xenon, peracetic gas or ultraviolet light options. We can control antibiotic use as much as we like but if we can’t improve basics like hand hygiene compliance and staff healthcare organisations with enough, well-trained and well-supported cleaning staff we have no chance of providing staff with rooms clean enough to protect patients from being a risk of develop a serious hospital infection. Obviously I appreciate the cost and effort required to implement new methods and technologies as well as current Australian research looking at bundled approaches (hand hygiene and traditional manual cleaning – both of which are likely ineffective in their current practice) but we really can no longer bury our heads about this issue and we need to give it priority.
________________________________
Infect Control Hosp Epidemiol. 2016 Sep 13:1-7. [Epub ahead of print]
Assessment of the Overall and Multidrug-Resistant Organism Bioburden on Environmental Surfaces in Healthcare Facilities.
Shams AM1, Rose LJ1, Edwards JR1, Cali S2, Harris AD3, Jacob JT4, LaFae A4, Pineles LL3, Thom KA3, McDonald LC1, Arduino MJ1, Noble-Wang JA1.
Author information* 11Division of Healthcare Quality Promotion,National Center for Emerging and Zoonotic Infectious Diseases,Centers for Disease Control and Prevention,Atlanta,Georgia.
* 22University of Illinois at Chicago School of Public Health,Chicago,Illinois.
* 33University of Maryland School of Medicine,Baltimore,Maryland.
* 44Emory University School of Medicine,Atlanta,Georgia.
Abstract
OBJECTIVE To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning. DESIGN Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2). SETTING MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states. PARTICIPANTS Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms). METHODS Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room. Composite 1 included the TV remote, telephone, call button, and bed rails. Composite 2 included the room door handle, IV pole, and overbed table. Composite 3 included toileting surfaces. Total bacteria and MDROs (ie, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci [VRE], Acinetobacter baumannii, Klebsiella pneumoniae, and C. difficile) were quantified, confirmed, and tested for drug resistance. RESULTS The mean microbial bioburden and range from routine cleaned room composites were higher (2,700 colony-forming units [CFU]/100 cm2; 1-130,000 CFU/100 cm2) than from terminal cleaned room composites (353 CFU/100 cm2; 1-4,300 CFU/100 cm2). MDROs were recovered from 34% of routine cleaned room composites (range 1-13,000 CFU/100 cm2) and 17% of terminal cleaned room composites (1-524 CFU/100 cm2). MDROs were recovered from 40% of rooms; VRE was the most common (19%). CONCLUSIONS This multicenter bioburden summary provides a first step to determining microbial bioburden on healthcare surfaces, which may help provide a basis for developing standards to evaluate cleaning and disinfection as well as a framework for studies using an evidentiary hierarchy for environmental infection control. Infect Control Hosp Epidemiol 2016;1-7.
Warm regards
CathCathryn Murphy MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4220
OLD, AustraliaE: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W: infectioncontrolplus.com.au______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.
You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au
______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.
You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.
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