Advertisement
Research Article| Volume 65, SUPPLEMENT 2, 50-54, June 2007

Download started.

Ok

Environmental contamination makes an important contribution to hospital infection

  • John M. Boyce
    Correspondence
    John M. Boyce, MD. Hospital of Saint Raphael, 1450 Chapel Street, New Haven, CT 06511, USA
    Affiliations
    Infectious Diseases Section, Hospital of Saint Raphael, New Haven, USA

    Yale University School of Medicine, New Haven, CT, USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Summary

      Meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are capable of surviving for days to weeks on environmental surfaces in healthcare facilities. Environmental surfaces frequently touched by healthcare workers are commonly contaminated in the rooms of patients colonized or infected with MRSA or VRE. A number of studies have documented that healthcare workers may contaminate their hands or gloves by touching contaminated environmental surfaces, and that hands or gloves become contaminated with numbers of organisms that are likely to result in transmission to patients. Pathogens may also be transferred directly from contaminated surfaces to susceptible patients. There is an increasing body of evidence that cleaning or disinfection of the environment can reduce transmission of healthcare-associated pathogens. Because routine cleaning of equipment items and other high-touch surfaces does not always remove pathogens from contaminated surfaces, improved methods of disinfecting the hospital environment are needed. Preliminary studies suggest that hydrogen peroxide vapour technology deserves further evaluation as a method for decontamination of the environment in healthcare settings.

      KEYWORDS

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hospital Infection
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Duckworth GJ
        • Jordens JZ
        Adherence and survival properties of an epidemic methicillin-resistant strain of Staphylococcus aureus compared with those of methicillin-sensitive strains.
        J Med Microbiol. 1990; 32: 195-200
        • Beard-Pegler MA
        • Stubbs E
        • Vickery AM
        Observations on the resistance to drying of staphylococcal strains.
        J Med Microbiol. 1988; 26: 251-255
        • Farrington M
        • Brenwald N
        • Haines D
        • Walpole E
        Resistance to desiccation and skin fatty acids in outbreak strains of methicillin-resistant Staphylococcus aureus.
        J Med Microbiol. 1992; 36: 56-60
        • Colbeck JC
        Environmental aspects of Staphylococcal infections acquired in hospitals.
        AJPH. 1960; 50: 468-473
        • Boyce JM
        • Potter-Bynoe G
        • Chenevert C
        • King T
        Environmental contamination due to methicillinresistant Staphylococcus aureus: possible infection control implications.
        Infect Control Hosp Epidemiol. 1997; 18: 622-627
      1. Otter JA, Havill NL, Adams NMT, Boyce JM. Extensive environmental contamination associated wtih patients with loose stools and methicillin-resistant Staphylococcus aureus colonization of the gastrointestinal tract. Presented at the 16th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America, Chicago, IL, 2006; abstract 159.

        • Johnston CP
        • Cooper L
        • Ruby W
        • Carroll KC
        • Cosgrove SE
        • Perl TM
        Epidemiology of communityacquired methicillin-resistant Staphylococcus aureus skin infections among healthcare workers in an outpatient clinic.
        Infect Control Hosp Epidemiol. 2006; 27: 1133-1136
        • Bhalla A
        • Pultz NJ
        • Gries DM
        • et al.
        Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients.
        Infect Control Hosp Epidemiol. 2004; 25: 164-167
        • French GL
        • Otter JA
        • Shannon KP
        • Adams NMT
        • Watling D
        • Parks MJ
        Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination.
        J Hosp Infect. 2004; 57: 31-37
        • Schultsz C
        • Meester HHM
        • Kranenburg AMH
        • et al.
        Ultrasonic nebulizers as a potential source of methicillinresistant Staphylococcus aureus causing an outbreak in a university tertiary care hospital.
        J Hosp Infect. 2003; 55: 269-275
        • Cotterill S
        • Evans R
        • Fraise AP
        An unusual source for an outbreak of methicillin-resistant Staphylococcus aureus on an intensive therapy unit.
        J Hosp Infect. 1996; 32: 207-216
        • Kumari DN
        • Haji TC
        • Keer V
        • Hawkey PM
        • Duncanson V
        • Flower E
        Ventilation grilles as a potential source of methicillin-resistant Staphylococcus aureus causing an outbreak in an orthopaedic ward at a district general hospital.
        J Hosp Infect. 1998; 39: 127-133
        • Hardy KJ
        • Oppenheim BA
        • Gossain S
        • Gao F
        • Hawkey PM
        A study of the relationship between environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and patients' acquisition of MRSA.
        Infect Control Hosp Epidemiol. 2006; 27: 127-132
        • Rampling A
        • Wiseman S
        • Davis L
        • et al.
        Evidence that hospital hygiene is important in the control of methicillin-resistant Staphylococcus aureus.
        J Hosp Infect. 2001; 49: 109-116
        • Noskin GA
        • Stosor V
        • Cooper I
        • Peterson LR
        Recovery of vancomycin-resistant enterococci on fingertips and environmental surfaces.
        Infect Control Hosp Epidemiol. 1995; 16: 577-581
        • Bonilla HF
        • Zervos MJ
        • Kauffman CA
        Long-term survival of vancomycin-resistant Enterococcus faecium on a contaminated surface.
        Infect Control Hosp Epidemiol. 1996; 17: 770-772
        • Wendt C
        • Wiesenthal B
        • Dietz E
        • Ruden H
        Survival of vancomycin-resistant and vancomycin-susceptible enterococci on dry surfaces.
        J Clin Microbiol. 1998; 36: 3734-3736
        • Weber DJ
        • Rutala WA
        Role of environmental contamination in the transmission of vancomycinresistant enterococci.
        Infect Control Hosp Epidemiol. 1997; 18: 306-309
        • Vernon MO
        • Hayden MK
        • Trick WE
        • Hayes RA
        • Blom DW
        • Weinstein RA
        Chlorhexidine gluconate to cleanse patients in a medical intensive care unit.
        Arch Intern Med. 2006; 166: 306-312
        • Boyce JM
        • Opal SM
        • Chow JW
        • et al.
        Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance.
        J Clin Microbiol. 1994; 32: 1148-1153
        • Bonten MJM
        • Hayden MK
        • Nathan C
        • et al.
        Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci.
        Lancet. 1996; 348: 1615-1619
        • Grabsch EA
        • Burrell LJ
        • Padiglione A
        • O'Keefe JM
        • Ballard S
        • Grayson ML
        Risk of environmental and healthcare worker contamination with vancomycinresistant enterococci during outpatient procedures and hemodialysis.
        Infect Control Hosp Epidemiol. 2006; 27: 287-293
        • Tenorio AR
        • Badri SM
        • Sahgal NB
        • et al.
        Effectiveness of gloves in preventing personnel handcarriage of vancomycin-resistant enterococcus (VRE) after patient care.
        Clin Infect Dis. 2001; 32: 826-829
        • Ray AJ
        • Hoyen CK
        • Taub TF
        • Donksey CJ
        Nosocomial transmission of vancomycin-resistant enterococci from surfaces.
        J Am Med Assoc. 2002; 287: 1400-1401
        • Duckro AN
        • Blom DW
        • Lyle EA
        • Weinstein RA
        • Hayden MK
        Transfer of vancomycin-resistant enterococci via health care worker hands.
        Arch Intern Med. 2005; 165: 302-307
        • Livornese LL
        • Dias S
        • Samel C
        • et al.
        Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers.
        Ann Intern Med. 1992; 117: 112-116
        • Porwancher R
        • Sheth A
        • Remphrey S
        • Taylor E
        • Hinkle C
        • Zervos M
        Epidemiological study of hospital-acquired infection with vancomycin-resistant Enterococcus faecium: possible transmission by an electronic ear-probe thermometer.
        Infect Control Hosp Epidemiol. 1997; 18: 771-773
        • Falk PS
        • Winnike J
        • Woodmansee C
        • Desai M
        • Mayhall CG
        Outbreak of vancomycin-resistant enterococci in a burn unit.
        Infect Control Hosp Epidemiol. 2000; 21: 575-582
        • Martinez JA
        • Ruthazer R
        • Hansjosten K
        • Barefoot L
        • Snydman DR
        Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci by inpatients treated in a medical intensive care unit.
        Arch Intern Med. 2003; 163: 1905-1912
        • Brooks S
        • Khan A
        • Stoica D
        • et al.
        Reduction in vancomycin-resistant Enterococcus and Clostridium difficile infections following change to tympanic thermometers.
        Infect Control Hosp Epidemiol. 1998; 19: 333-336
        • Hayden MK
        • Bonten MJ
        • Blom DW
        • Lyle EA
        • van de Vijver DA
        • Weinstein RA
        Reduction in acquisition of vancomycin-resistant Enterococcus after enforcement of routine environmental cleaning measures.
        Clin Infect Dis. 2006; 42: 1552-1560
      2. Boyce JM, Havill NL, Otter JA, et al. Impact of hydrogen peroxide vapor room bio-decontamination on environmental contamination and nosocomial transmission by Clostridium difficile. Presented at the 16th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America, Chicago, IL, 2006; abstract 155.