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Microbial burden on environmental surfaces in patient rooms before daily cleaning—Analysis of multiple confounding variables

Published online by Cambridge University Press:  16 August 2021

John M. Boyce Open the ORCID record for John M. Boyce [Opens in a new window] ,
Nancy L. Havill ,
Kerri A. Guercia  and
Brent A. Moore
John M. Boyce*
Affiliation:
Yale-New Haven Hospital, New Haven, Connecticut Yale University School of Medicine, New Haven, Connecticut [Present affiliation: J.M. Boyce Consulting, Middletown, CT (J.M.B.)]
Nancy L. Havill
Affiliation:
Yale-New Haven Hospital, New Haven, Connecticut
Kerri A. Guercia
Affiliation:
Yale-New Haven Hospital, New Haven, Connecticut
Brent A. Moore
Affiliation:
Yale University School of Medicine, New Haven, Connecticut [Present affiliation: J.M. Boyce Consulting, Middletown, CT (J.M.B.)]
*
Author for correspondence: John M. Boyce, E-mail: jmboyce69@gmail.com.
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Abstract

Objectives:

Estimated levels of microbial burden on hospital environmental surfaces vary substantially among published studies. Cultures obtained during a cluster-controlled crossover trial of a quaternary ammonium (Quat) disinfectant versus an improved hydrogen peroxide (IHP) disinfectant provided additional data on the amount of microbial burden on selected surfaces.

Methods:

RODAC plates containing D/E neutralizing agar were used to sample a convenience sample of 5–8 high-touch surfaces in patient rooms on 2 medical wards, an intensive care unit, and a step-down unit at a large hospital. Before routine daily cleaning, samples were obtained in varying rooms over an 11-month period. RODAC plates (1 per surface sampled) were incubated for 72 hours, and aerobic colony counts per plate (ACCs) were determined. Statistical analysis was used to determine the potential impact on ACCs of study period, cleaning compliance rate, disinfectant used, ward, surface sampled, and isolation room status.

Results:

Overall, 590 cultures were obtained on Quat wards and 589 on IHP wards. Multivariable regression analysis revealed that mean ACCs differed significantly by site (P < .001), type of ward (P < .001), isolation room status (P = .039), and study period (P = .036). The highest mean ACCs per RODAC plate were on toilet seats (112.8), bedside rails (92.0), and bathroom grab bars (79.5).

Conclusions:

The combination of factors analyzed revealed that estimating microbial burden is complex and is affected by multiple factors. Additional studies should evaluate individual sites, ward types, cleaning and disinfection practices, and isolation room status.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 9 , September 2022 , pp. 1142 - 1146
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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