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

Beatrice Casini, Anna Righi, Nunzio De Feo, Michele Totaro, Serena Giorgi, Lavinia Zezza, Paola Valentini, Enrico Tagliaferri, Anna Laura Costa, Simona Barnini, Angelo Baggiani, Pietro Luigi Lopalco, Paolo Malacarne and Gaetano Pierpaolo Privitera
Additional contact information
Beatrice Casini: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Anna Righi: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Nunzio De Feo: Anesthesia and Intensive Care Unit PS, University Hospital, 56124 Pisa, Italy
Michele Totaro: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Serena Giorgi: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Lavinia Zezza: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Paola Valentini: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Enrico Tagliaferri: Infectious Disease Unit, University Hospital, 56124 Pisa, Italy
Anna Laura Costa: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Simona Barnini: Unit of Microbiology, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy
Angelo Baggiani: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Pietro Luigi Lopalco: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy
Paolo Malacarne: Anesthesia and Intensive Care Unit PS, University Hospital, 56124 Pisa, Italy
Gaetano Pierpaolo Privitera: Department of Translational Research, N.T.M.S., University of Pisa, 56123 Pisa, Italy

IJERPH, 2018, vol. 15, issue 10, 1-9

Abstract: 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 cm 2 ). 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 cm 2 (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.

Keywords: high-touch surfaces; carbapenem-resistant A. baumannii; pre-impregnated wipes; outsourced cleaning services (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
https://www.mdpi.com/1660-4601/15/10/2305/pdf (application/pdf)
https://www.mdpi.com/1660-4601/15/10/2305/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:15:y:2018:i:10:p:2305-:d:176956

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().