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Improving Cleaning and Disinfection of High-Touch Surfaces in Intensive Care during Carbapenem-Resistant Acinetobacter baumannii Endemo-Epidemic Situations

1
Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
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Anesthesia and Intensive Care Unit PS, University Hospital, 56124 Pisa, Italy
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Infectious Disease Unit, University Hospital, 56124 Pisa, Italy
4
Unit of Microbiology, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(10), 2305; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15102305
Received: 4 September 2018 / Revised: 10 October 2018 / Accepted: 17 October 2018 / Published: 19 October 2018
Aims: High-touch surfaces cleaning and disinfection require the adoption of effective and proper executed protocols, especially during carbapenem-resistant Acinetobacter baumannii (CRAB) endemo-epidemic situations. We evaluated the effectiveness and residual disinfectant activity of disposable pre-impregnated wipes (Modified Operative Protocol, MOP) in reducing environmental bioburden versus a two-step Standard Operative Protocol (SOP) in a 12-bed Intensive Care Unit. Methods: Five high-touch surfaces were cleaned and disinfected either according to the SOP (alcohol-based cleaning and chlorine-based disinfection) or using quaternary ammonium compounds-based disposable wipes (MOP). Sampling was performed before each procedure and at 0.5, 2.5, 4.5 and 6.5 h after (560 sites). Total viable count (TVC) was evaluated according to Italian hygiene standard (<50 CFU/24 cm2). Clinical and environmental CRAB strains isolated were genotyped. Results: On non-electromedical surfaces the difference between TVC before procedure and at each of the following times was significant only for the MOP (p < 0.05, Wilcoxon test). Using the MOP, only 7.4% (10/135) of sites showed TVC >50 CFU/24 cm2 (hygiene failures) versus 18.9% (25/132) after SOP (p < 0.05, Fisher’s Exact test). On infusion pumps a higher number of hygiene failures was observed after the SOP (7/44, 15.9%) compared with the MOP (4/45, 8.9%). Genotyping highlighted a common source of infection. Conclusion: On high-touch surfaces, the use of disposable wipes by in-house auxiliary nurses may represent a more effective alternative to standard cleaning and disinfection procedure performed by outsourced cleaning services, showing effectiveness in reducing microbial contamination and residual disinfection activity up to 6.5 h. View Full-Text
Keywords: high-touch surfaces; carbapenem-resistant A. baumannii; pre-impregnated wipes; outsourced cleaning services high-touch surfaces; carbapenem-resistant A. baumannii; pre-impregnated wipes; outsourced cleaning services
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MDPI and ACS Style

Casini, B.; Righi, A.; De Feo, N.; Totaro, M.; Giorgi, S.; Zezza, L.; Valentini, P.; Tagliaferri, E.; Costa, A.L.; Barnini, S.; Baggiani, A.; Lopalco, P.L.; Malacarne, P.; Privitera, G.P. Improving Cleaning and Disinfection of High-Touch Surfaces in Intensive Care during Carbapenem-Resistant Acinetobacter baumannii Endemo-Epidemic Situations. Int. J. Environ. Res. Public Health 2018, 15, 2305. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15102305

AMA Style

Casini B, Righi A, De Feo N, Totaro M, Giorgi S, Zezza L, Valentini P, Tagliaferri E, Costa AL, Barnini S, Baggiani A, Lopalco PL, Malacarne P, Privitera GP. Improving Cleaning and Disinfection of High-Touch Surfaces in Intensive Care during Carbapenem-Resistant Acinetobacter baumannii Endemo-Epidemic Situations. International Journal of Environmental Research and Public Health. 2018; 15(10):2305. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15102305

Chicago/Turabian Style

Casini, Beatrice, Anna Righi, Nunzio De Feo, Michele Totaro, Serena Giorgi, Lavinia Zezza, Paola Valentini, Enrico Tagliaferri, Anna L. Costa, Simona Barnini, Angelo Baggiani, Pietro L. Lopalco, Paolo Malacarne, and Gaetano P. Privitera 2018. "Improving Cleaning and Disinfection of High-Touch Surfaces in Intensive Care during Carbapenem-Resistant Acinetobacter baumannii Endemo-Epidemic Situations" International Journal of Environmental Research and Public Health 15, no. 10: 2305. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15102305

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