Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a bleach-based cleaning–disinfection programme

Grabsch, Elizabeth A; Mahony, Andrew A; Cameron, D. W.; Martin, Rhea; Heland, Melodie; Davey, Peter; Petty, M; Xie, Shirley; Grayson, M Lindsay

doi:10.1016/j.jhin.2012.08.010

Cited by 58 publications

(47 citation statements)

References 26 publications

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“…A comparable study described implementation of a multicomponent package, also based on bleach disinfection, as a response to increasing numbers of patients with VRE (61). Additional cleaning supervisors were appointed to manage the introduction and delivery of a standardized cleaning regimen using a novel product containing detergent and sodium hypochlorite (1,000 ppm).…”

Section: Vrementioning

confidence: 99%

“…Susceptible enterococcal infection may well derive from the patient's own endogenous flora, whereas resistant enterococci are more likely to be acquired from persistent surface reservoirs. The "bleach-clean" package encouraged the decline in new VRE acquisition among particularly vulnerable patients alongside an overall reduction in VRE bacteremia rate throughout the hospital (61).…”

Section: Vrementioning

confidence: 99%

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Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

2014

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SUMMARY There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens.

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Section: Vrementioning

confidence: 99%

Section: Vrementioning

confidence: 99%

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

2014

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“…Development of VRE colonization can lead to a lifethreatening complication especially in the immunosuppressed patients 26 . Similarly to the other studies, in this study we found the risk factors for VRE colonization as the existence of malignancy, renal failure requiring dialysis and concomitant Alzheimer's disease.…”

Section: Discussionmentioning

confidence: 99%

Importance Of The Rısk Factors For Vancomycın Resıstant Enterococcus Infectıon/Colonızatıon Development In Tertıary Intensıve Care Unıts

Erdem¹,

Kanyılmaz²,

Akan³

et al. 2016

Kafkas J Med Sci

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“…42 Bleach is more effective in C. difficile and VRE terminal cleans 43 but can be caustic to surfaces and elicits HCW sensitivity. Several proprietary antiseptic wipes are increasingly used for surface cleaning and to decontaminate equipment with good outcomes and greater staff acceptability.…”

Section: Cleaning Methodsmentioning

confidence: 99%

Healthcare‐acquired infections: prevention strategies

Fernando

Gray

Gottlieb

2017

Internal Medicine Journal

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Healthcare‐acquired infections (HAI) impact on patient care and have cost implications for the Australian healthcare system. The management of HAI is exacerbated by rising rates of antimicrobial resistance (AMR). Health‐care workers and a contaminated hospital environment are increasingly implicated in the transmission and persistence of multi‐resistant organisms (MRO), as well as other pathogens, such as Clostridium difficile. This has resulted in a timely focus on a range of HAI prevention actions. Core components include antimicrobial stewardship, to reduce overuse and ensure evidence‐based antimicrobial use; infection prevention strategies, to control MRO – particularly methicillin‐resistant Staphylococcus aureus (MRSA), vancomycin‐resistant Enterococcus spp. (VRE) and, more recently, multi‐resistant Gram‐negative bacteria; enhanced institutional investment in hand hygiene; hospital cleaning and disinfection; and the development of prescribing guidelines and standards of care. AMR surveillance and comparisons of prescribing are useful feedback activities once effectively communicated to end users. Successful implementation of these strategies requires cultural shifts at local hospital level and, to tackle the serious threat posed by AMR, greater co‐ordination at a national level. HAI prevention needs to be multi‐modal, requires broad healthcare collaboration, and the strong support and accountability of all medical staff.

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Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a bleach-based cleaning–disinfection programme

Cited by 58 publications

References 26 publications

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

Importance Of The Rısk Factors For Vancomycın Resıstant Enterococcus Infectıon/Colonızatıon Development In Tertıary Intensıve Care Unıts

Healthcare‐acquired infections: prevention strategies

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