Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

Abstract

Objective: To investigate the timing and routes of contamination of the rooms of patients newly admitted to the hospital. Design: Observational cohort study and simulations of pathogen transfer. Setting: A Veterans’ Affairs hospital. Participants: Patients newly admitted to the hospital with no known carriage of healthcare-associated pathogens. Methods: Interactions between the participants and personnel or portable equipment were observed, and cultures of high-touch surfaces, floors, bedding, and patients’ socks and skin were collected for up to 4 days. Cultures were processed for Clostridioides difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Simulations were conducted with bacteriophage MS2 to assess plausibility of transfer from contaminated floors to high-touch surfaces and to assess the effectiveness of wearing slippers in reducing transfer. Results: Environmental cultures became positive for at least 1 pathogen in 10 (59%) of the 17 rooms, with cultures positive for MRSA, C. difficile, and VRE in the rooms of 10 (59%), 2 (12%), and 2 (12%) participants, respectively. For all 14 instances of pathogen detection, the initial site of recovery was the floor followed in a subset of patients by detection on sock bottoms, bedding, and high-touch surfaces. In simulations, wearing slippers over hospital socks dramatically reduced transfer of bacteriophage MS2 from the floor to hands and to high-touch surfaces. Conclusions: Floors may be an underappreciated source of pathogen dissemination in healthcare facilities. Simple interventions such as having patients wear slippers could potentially reduce the risk for transfer of pathogens from floors to hands and high-touch surfaces.

Isolation of Clostridioides difficile PCR Ribotype 027 from single-use hospital gown ties

“…Hospital floors are an important pathogen reservoir lending to the easy spread of disinfection-resilient pathogens such as C. difficile [32,33]. The role of flooring in aiding the spread of pathogens through vectors such as shoes, socks and even wheelchairs has become a subject of interest in recent years with pathogens including methicillin resistant Staphylococcus aureus, C. difficile spores and common viruses being studied [6,7,[32][33][34][35]. Indeed a clear limitation of this study is the lack of environmental sampling, meaning that while the presence of C. difficile was confirmed on the gown ties, the nosocomial source of C. difficile was not identified.…”

“…Hospital floors are an important pathogen reservoir lending to the easy spread of disinfection-resilient pathogens such as C. difficile [32, 33]. The role of flooring in aiding the spread of pathogens through vectors such as shoes, socks and even wheelchairs has become a subject of interest in recent years with pathogens including methicillin resistant Staphylococcus aureus , C.…”

“…The role of flooring in aiding the spread of pathogens through vectors such as shoes, socks and even wheelchairs has become a subject of interest in recent years with pathogens including methicillin resistant Staphylococcus aureus , C. difficile spores and common viruses being studied [6, 7, 32–35]. Indeed a clear limitation of this study is the lack of environmental sampling, meaning that while the presence of C.…”

“…These contaminated surfaces range from flooring to bedpans, hospital equipment and the hands of HCWs, often leading to increased infection case rates and implementation of infection control practices to prevent pathogen transmission [7,31]. Hospital floors are an important pathogen reservoir lending to the easy spread of disinfection-resilient pathogens such as C. difficile [32,33]. The role of flooring in aiding the spread of pathogens through vectors such as shoes, socks and even wheelchairs has become a subject of interest in recent years with pathogens including methicillin resistant Staphylococcus aureus, C. difficile spores and common viruses being studied [6,7,[32][33][34][35].…”

Is the Antibacterial Activity of Multi-Walled Carbon Nanotubes (MWCNTs) Related to Antibiotic Resistance? An Assessment in Clinical Isolates

“…A large number of studies have highlighted that hospital surfaces (beds, beside tables, carts, door handles, taps, mobile phones, computers, humidifiers for oxygen therapy, etc.) can host many nosocomial pathogens and could play an important role in the onset of hospital-acquired infections [4][5][6][7][8][9][10].…”