A Prospective Study of Transmission of Multidrug-Resistant Organisms (MDRO) Between Environmental Sites and Hospitalized Patients: The TransFER Study

Enhanced disinfection leads to reduction of microbial contamination and a decrease in patient colonization and infection

“…This substudy of the BETR Disinfection Study was a pragmatic, prospective, multicenter, cluster-randomized trial that evaluated 4 different strategies for terminal room disinfection in 9 hospitals from April 2012 through July 2014. 6,8 We performed microbiological analysis of randomly selected "seed" rooms to determine the total and average number of colony-forming units (CFU) of the 4 target organisms that remained in the patient room following terminal room decontamination at 3 study hospitals in central North Carolina: Duke University Hospital, a 921-bed tertiary-care academic medical center; Duke Regional Hospital, a 250-bed community hospital; and Duke Raleigh Hospital, a 148-bed community hospital. A seed room was defined as a single-patient room from which a patient on contact precautions was discharged or transferred.…”

“…6 In brief, at each study visit, microbiological samples were collected from 8 of 10 environmental surfaces in the hospital room of the enrolled subject; these surfaces included the bed rail, over-bed table, supply or medicine cart, chair, sink, toilet seat, shower floor, side counter, linen hamper lid, and bathroom floor. 6,8,9 Each surface area was sampled in a different location using 10 individual replicate organism detection and counting (Rodac) plates (Becton Dickinson, Franklin Lakes, NJ) to enhance microbiological yield and to reduce sampling error: 5 Rodacs for aerobic culture (~125 cm 2 ) and 5 for anaerobic culture (Anaeropack, Mitsubishi Gas Chemical). Each Rodac plate sampled~25 cm 2 .…”

“…Microbiological analyses and identification were performed using standard protocols. 6,8 We attempted to sample 25 rooms for each EIP: MRSA, VRE, Acinetobacter, and C. difficile. No other selection criteria were used.…”

Effectiveness of dry hydrogen peroxide on reducing environmental microbial bioburden risk in a pediatric oncology intensive care unit

“…3 Studies such as that by Shams et al in which C. difficile was recovered from 50% of patient rooms after manual cleaning or that by Chen et al which found that 55% of patient rooms remained contaminated with multidrug-resistant organisms, including MRSA and multidrug-resistant Acinetobacter, despite terminal manual cleaning and disinfection underscore this inadequacy. 4,38 Variability in both staff performance and compliance with cleaning protocols, material and product compatibility, and high environmental services staff turnover rates are among the many factors that may render manual cleaning efforts suboptimal. Automated, "no-touch" decontamination technologies have been developed to address this problem.…”