Cleaning and disinfecting surfaces in hospitals and long-term care facilities for reducing hospital- and facility-acquired bacterial and viral infections: a systematic review

Thomas, Bennett C; Conly, John; Lorenzetti, Diane

doi:10.1016/j.jhin.2021.12.017

Cited by 18 publications

(12 citation statements)

References 34 publications

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“…This finding might contribute to further comprehensive, multicomponent environmental cleaning and disinfection intervention. However, the optimal cleaning interval for nonpatient-care areas remains unresolved due to a lack of prospective comparison studies and the ecological complexity of healthcare settings [ 17 , 21 ]. In addition, there is a wide variety of biological material that is measured by using ATP, of which the bacterial load is only one of many components.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, updated guidelines or reviews always highlight the importance of cleaning and disinfecting surfaces in hospitals [ 16 , 17 , 18 ]. Globally, one of the most popular methods to evaluate the quality of cleaning is the adenosine triphosphate (ATP) bioluminescence assay, which provides rapid feedback on bacterial load and bioburden monitoring [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Plastic-Wrap Properties and Cleaning Intervals on the Disinfection of Elevator Buttons

Kuo

Liu

Chen

et al. 2023

IJERPH

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Fomite transmission is a possible route by which different pathogens spread within facilities. In hospital settings, elevator buttons are widely observed to be covered with various types of plastic wraps; however, limited information is available concerning the impact of different plastic materials on cleaning. Our study aimed to identify which plastic material is suitable for the coverage of elevator buttons and the optimal intervals for their cleaning. We tested six plastic covers, including polyethylene (PE), polymethylpentene (PMP), polyvinyl chloride (PVD), and polyvinylidene chloride (PVDC) plastic wraps; a thermoplastic polyurethane (TPU) keyboard cover; and a polyethylene terephthalate-ethylene vinyl acetate (PET-EVA) laminating film, which are plastic films. The bioburden on the elevator buttons at different time intervals was measured using an adenosine triphosphate (ATP) bioluminescence assay. Our results show that wraps made of PVDC had superior durability compared with those of PMP, PVC, and PVDC, in addition to the lowest detectable ATP levels among the six tested materials. Regarding different button locations, the highest ATP values were found in door-close buttons followed by door-open, and first-floor buttons after one- and three-hour intervals (p = 0.024 and p < 0.001, respectively). After routine disinfection, the ATP levels of buttons rapidly increased after touching and became more prominent after three hours (p < 0.05). Our results indicate that PVDC plastic wraps have adequate durability and the lowest residual bioburden when applied as covers for elevator buttons. Door-close and -open buttons were the most frequently touched sites, requiring more accurate and precise disinfection; therefore, cleaning intervals of no longer than three hours may be warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of Plastic-Wrap Properties and Cleaning Intervals on the Disinfection of Elevator Buttons

Kuo

Liu

Chen

et al. 2023

IJERPH

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“…Earlier studies have shown that improved surface disinfection can decrease environmental contamination of healthcare-associated pathogens and subsequently decrease the likelihood of patients acquiring HAIs. 1…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a Filtered Far-UVC Handheld Disinfection Device on Reducing Microbial Bioburden of Hospital Surfaces

Navarathna

Corona

Coppin

et al. 2022

Preprint

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Objectives The Filtered Far UVC handheld disinfection device is a small portable device that emits far UVC at 222nm. The objective of this study was to evaluate the devices ability to kill microbial bioburden on hospital surfaces and compare it to manual cleaning using germicidal sodium hypochlorite wipes. Methods A total of 344 surfaces (86 observations per group) were sampled with 2 pairs of samples per surface a pre and a post sodium hypochlorite sample, and a pre and a post FFUV sample. The results were analyzed via a Bayesian multi level model that account for the correlation between sample pairs and within surfaces. Additionally, the bacterial flora recovered was identified. Results The estimated mean colony counts for the sodium hypochlorite control and treatment groups were 20.5 (11.7 to 36.0) and 0.1 (0.0 to 0.2) colony forming units (CFUs) respectively. The FFUV control and treatment groups had mean colony counts of 22.2 (12.5 to 40.1) and 4.1 (2.3 to 7.2) CFUs. The sodium hypochlorite samples had an estimated 99.4% (99.0% to 99.7%) reduction in colony counts, while those from the FFUV group an estimated 81.4% (76.2% to 85.7%) reduction. Conclusions The findings from this study suggest the FFUV handheld device effectively reduced microbial bioburden on real world hospital surfaces; however, a manual clean using sodium hypochlorite was more effective in reducing bioburden. Several healthcare associated infections causing pathogens (gram positive and negative bacteria) were retrieved from the surfaces indicating a potential for onward transmission.

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“…Environmental surfaces in healthcare facilities readily become contaminated with pathogens and these play a vital role in terms of disease transmission [ 3 , 4 , 5 ]. The risk of pathogen transmission is reduced by environmental cleaning and disinfection [ 6 , 7 ]; however, biofilm formation on the surfaces in these settings complicates environmental decontamination as biofilms are more difficult to remove by cleaning agents and are more tolerant of disinfectants [ 8 , 9 , 10 , 11 , 12 , 13 ]. They, therefore, can function as reservoirs of pathogens in the hospital setting and provide favourable environments for the long-term persistence of pathogens [ 8 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

One Step Forward with Dry Surface Biofilm (DSB) of Staphylococcus aureus: TMT-Based Quantitative Proteomic Analysis Reveals Proteomic Shifts between DSB and Hydrated Biofilm

Rahman

Amirkhani

Parvin

et al. 2022

IJMS

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The Gram-positive bacterium Staphylococcus aureus is responsible for serious acute and chronic infections worldwide and is well-known for its biofilm formation ability. Recent findings of biofilms on dry hospital surfaces emphasise the failures in current cleaning practices and disinfection and the difficulty in removing these dry surface biofilms (DSBs). Many aspects of the formation of complex DSB biology on environmental surfaces in healthcare settings remains limited. In the present study, we aimed to determine how the protein component varied between DSBs and traditional hydrated biofilm. To do this, biofilms were grown in tryptic soy broth (TSB) on removable polycarbonate coupons in the CDC biofilm reactor over 12 days. Hydrated biofilm (50% TSB for 48 h, the media was then changed every 48 h with 20% TSB, at 37 °C with 130 rpm). DSB biofilm was produced in 5% TSB for 48 h at 35 °C followed by extended periods of dehydration (48, 66, 42 and 66 h at room temperature) interspersed with 6 h of 5% TSB at 35 °C. Then, we constructed a comprehensive reference map of 12-day DSB and 12-day hydrated biofilm associated proteins of S. aureus using a high-throughput tandem mass tag (TMT)-based mass spectrometry. Further pathway analysis of significantly differentially expressed identified proteins revealed that proteins significantly upregulated in 12-day DSB include PTS glucose transporter subunit IIBC (PtaA), UDP-N-acetylmuramate-L-alanine ligase (MurC) and UDP-N-acetylenolpyruvoylglucosamine (MurB) compared to 12-day hydrated biofilm. These three proteins are all linked with peptidoglycan biosynthesis pathway and are responsible for cell-wall formation and thicker EPS matrix deposition. Increased cell-wall formation may contribute to the persistence of DSB on dry surfaces. In contrast, proteins associated with energy metabolisms such as phosphoribosyl transferase (PyrR), glucosamine--fructose-6-phosphate aminotransferase (GlmS), galactose-6-phosphate isomerase (LacA), and argininosuccinate synthase (ArgG) were significantly upregulated whereas ribosomal and ABC transporters were significantly downregulated in the 12-day hydrated biofilm compared to DSB. However, validation by qPCR analysis showed that the levels of gene expression identified were only partially in line with our TMT-MS quantitation analysis. For the first time, a TMT-based proteomics study with DSB has shed novel insights and provided a basis for the identification and study of significant pathways vital for biofilm biology in this reference microorganism.

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Cleaning and disinfecting surfaces in hospitals and long-term care facilities for reducing hospital- and facility-acquired bacterial and viral infections: a systematic review

Cited by 18 publications

References 34 publications

Impact of Plastic-Wrap Properties and Cleaning Intervals on the Disinfection of Elevator Buttons

Impact of Plastic-Wrap Properties and Cleaning Intervals on the Disinfection of Elevator Buttons

Efficacy of a Filtered Far-UVC Handheld Disinfection Device on Reducing Microbial Bioburden of Hospital Surfaces

One Step Forward with Dry Surface Biofilm (DSB) of Staphylococcus aureus: TMT-Based Quantitative Proteomic Analysis Reveals Proteomic Shifts between DSB and Hydrated Biofilm

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