Microbial Load on Environmental Surfaces: The Relationship Between Reduced Environmental Contamination and Reduction of Healthcare-Associated Infections

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ID WEEK 2016
POSTER ABSTRACTS
262. Microbial Load on Environmental Surfaces: The Relationship Between
Reduced Environmental Contamination and Reduction of Healthcare-
Associated Infections
William Rutala, PhD, MPH1; Hajime Kanamori, MD, PhD, MPH2; Maria Gergen, MT
(ASCP)1; Emily Sickbert-Bennett, PhD, MS2; Lauren Knelson, MSPH3; Luke F. Chen,
MBBS, MPH, MBA, CIC, FRACP4; Daniel Sexton, MD4; Deverick Anderson, MD,
MPH, FIDSA, FSHEA4; David J. Weber, MD, MPH, FIDSA, FSHEA5;
1
Hospital
Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina;
2
Division of Infectious Diseases, University of North Carolina School of Medicine,
Chapel Hill, North Carolina;
3
Duke University Medical Center, Durham, North
Carolina;
4
Division of Infectious Diseases, Duke University Medical Center, Durham,
North Carolina;
5
Medicine, Pediatrics, Epidemiology, University of North Carolina,
School of Public Health, Chapel Hill, North Carolina
Session: 53. HAI: Environment and Device Cleaning
Thursday, October 27, 2016: 12:30 PM
Background.Disinfection of noncritical environmental surfaces and equipment is
an essential component of infection prevention as surfaces may contribute to cross-
transmission of epidemiologically important pathogens. We monitored 4 epidemiolog-
ically important pathogens (EIP), including MRSA, VRE, C. difficile and MDR-Acine-
tobacter. The current study was performed in 2 hospitals contemporaneously with the
BETR-Disinfection study, a multi-center cross-over study comparing the feasibility
and effectiveness of 3 enhanced disinfection strategies for terminal room disinfection
against standard practice.
Methods.Microbiological samples were collected from 8 previous ly identified
high-frequency-t ouch hospital room surfaces. Each surface was sampled repeatedly
using 10 individual Rodac plates (25 cm
2
/plate).
Results.All enhanced disinfection interventions (i.e. Quat/UV, Bleach, Bleach/
UV) were significantly superior to a Quat alone in reducing EIP (table). The BETR-
Disinfection study demonstrated the rate of colonization/infection in a patient subse-
quently admitted to a room of a patient colonized/infected with an EIP was Quat, 2.3%;
Quat/UV, 1.5%; Bleach, 1.9%, and Bleach/UV, 2.2%.
Conclusion.Comparing the best strategy with the worst strategy (i.e. Quat versus
Quat/UV) revealed that a reduction of 94% in EIP (60.8 versus 3.36) led to a 35% de-
crease in colonization/infection (2.3% versus 1.5%). Our data demonstrated that a de-
crease in room contamination was associated with a decrease in subsequent patient
colonization/infection.
Disclosures. W. Rutala, Clorox: Consultant, Scientific Advisor and Speaker’s Bu-
reau, Consulting fee, Speaker honorarium and Unrestricted gift for research
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Table: EIP (Mean CFUs/Room) by Intervention and Contamination in Patient Rooms
MDR-
Acinetobacter C. difficile MRSA VRE EIP
Intervention Room
Room/
BR Room
Room/
BR Room
Room/
BR Room
Room/
BR Room
Room/
BR
Quat 8.76 8.95 0 3.76 2.33 8.52 8.62 39.6 19.71 60.8
Quat/UV 0.18 0.17 0.07 2.86 0.11 0.11 0.07 0.21 0.43 3.36
Bleach 0.39 0.39 0.04 4.48 2.13 4.39 0.78 2.43 3.35 11.7
Bleach/UV 0.25 0.25 0 3.25 0.05 0.85 0.35 1.90 0.65 6.25
Quat, quaternary ammonium; BR, bathroom.
Statistical significance (p < 0.05) was evaluated by the Student’s t-test for all EIP in room alone (room plus
bathroom): Quat versus Quat/UV, p = 0.0025 ( p = 0.0128); Quat versus Bleach/UV, p = 0.0055 (p = 0. 0284);
Quat versus Bleach, p = 0.0132 ( p = 0.0408).
Open Forum Infectious Diseases 2016;1(S1):S1–285
© The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases
Society of Americ a. This is an Open Access artic le distributed under the t erms of the Creative
Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/
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DOI: 10.1093/ofid/ofw172
Poster Abstracts •OFID 2016:1 (Suppl 1) •S1