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Improving Cleaning and Disinfection of High-Touch Surfaces in Intensive Care during Carbapenem-Resistant Acinetobacter baumannii Endemo-Epidemic Situations

Author

Listed:
  • Beatrice Casini

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Anna Righi

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Nunzio De Feo

    (Anesthesia and Intensive Care Unit PS, University Hospital, 56124 Pisa, Italy)

  • Michele Totaro

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Serena Giorgi

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Lavinia Zezza

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Paola Valentini

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Enrico Tagliaferri

    (Infectious Disease Unit, University Hospital, 56124 Pisa, Italy)

  • Anna Laura Costa

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Simona Barnini

    (Unit of Microbiology, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy)

  • Angelo Baggiani

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Pietro Luigi Lopalco

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

  • Paolo Malacarne

    (Anesthesia and Intensive Care Unit PS, University Hospital, 56124 Pisa, Italy)

  • Gaetano Pierpaolo Privitera

    (Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy)

Abstract

Aims: High-touch surfaces cleaning and disinfection require the adoption of effective and proper executed protocols, especially during carbapenem-resistant Acinetobacter baumannii (CRAB) endemo-epidemic situations. We evaluated the effectiveness and residual disinfectant activity of disposable pre-impregnated wipes (Modified Operative Protocol, MOP) in reducing environmental bioburden versus a two-step Standard Operative Protocol (SOP) in a 12-bed Intensive Care Unit. Methods: Five high-touch surfaces were cleaned and disinfected either according to the SOP (alcohol-based cleaning and chlorine-based disinfection) or using quaternary ammonium compounds-based disposable wipes (MOP). Sampling was performed before each procedure and at 0.5, 2.5, 4.5 and 6.5 h after (560 sites). Total viable count (TVC) was evaluated according to Italian hygiene standard (<50 CFU/24 cm 2 ). Clinical and environmental CRAB strains isolated were genotyped. Results: On non-electromedical surfaces the difference between TVC before procedure and at each of the following times was significant only for the MOP ( p < 0.05, Wilcoxon test). Using the MOP, only 7.4% (10/135) of sites showed TVC >50 CFU/24 cm 2 (hygiene failures) versus 18.9% (25/132) after SOP ( p < 0.05, Fisher’s Exact test). On infusion pumps a higher number of hygiene failures was observed after the SOP (7/44, 15.9%) compared with the MOP (4/45, 8.9%). Genotyping highlighted a common source of infection. Conclusion: On high-touch surfaces, the use of disposable wipes by in-house auxiliary nurses may represent a more effective alternative to standard cleaning and disinfection procedure performed by outsourced cleaning services, showing effectiveness in reducing microbial contamination and residual disinfection activity up to 6.5 h.

Suggested Citation

  • Beatrice Casini & Anna Righi & Nunzio De Feo & Michele Totaro & Serena Giorgi & Lavinia Zezza & Paola Valentini & Enrico Tagliaferri & Anna Laura Costa & Simona Barnini & Angelo Baggiani & Pietro Luig, 2018. "Improving Cleaning and Disinfection of High-Touch Surfaces in Intensive Care during Carbapenem-Resistant Acinetobacter baumannii Endemo-Epidemic Situations," IJERPH, MDPI, vol. 15(10), pages 1-9, October.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:10:p:2305-:d:176956
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    References listed on IDEAS

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    1. Toffolutti, Veronica & Reeves, Aaron & McKee, Martin & Stuckler, David, 2017. "Outsourcing cleaning services increases MRSA incidence: Evidence from 126 english acute trusts," Social Science & Medicine, Elsevier, vol. 174(C), pages 64-69.
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    Cited by:

    1. Elizabeth C. Christenson & Ryan Cronk & Helen Atkinson & Aayush Bhatt & Emilio Berdiel & Michelle Cawley & Grace Cho & Collin Knox Coleman & Cailee Harrington & Kylie Heilferty & Don Fejfar & Emily J., 2021. "Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities," IJERPH, MDPI, vol. 18(21), pages 1-22, October.
    2. Beatrice Casini & Benedetta Tuvo & Maria Luisa Cristina & Anna Maria Spagnolo & Michele Totaro & Angelo Baggiani & Gaetano Pierpaolo Privitera, 2019. "Evaluation of an Ultraviolet C (UVC) Light-Emitting Device for Disinfection of High Touch Surfaces in Hospital Critical Areas," IJERPH, MDPI, vol. 16(19), pages 1-10, September.

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