Study on the effectiveness of disinfection with wipes against methicillin-resistant staphylococcus aureus (MRSA) and implications for hospital hygiene

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Study on the effectiveness of disinfection with wipes against methicillin-resistant staphylococcus aureus (MRSA) and implications for hospital hygiene

 

Author: Cheng, Ka-lam
Title: Study on the effectiveness of disinfection with wipes against methicillin-resistant staphylococcus aureus (MRSA) and implications for hospital hygiene
Degree: M.Sc.
Year: 2010
Subject: Hong Kong Polytechnic University -- Dissertations
Staphylococcus aureus -- Prevention
Hospitals -- Disinfection
Disinfection and disinfectants -- Environmental aspects
Department: Faculty of Health and Social Sciences
Pages: xii, 96 leaves : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2356824
URI: http://theses.lib.polyu.edu.hk/handle/200/5698
Abstract: Environmental contamination with Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant risk in the epidemiology of infection. This study aimed to assess the effectiveness of disinfection in clinical areas, by assessment of the wipe-rinse method to detect an indicator organism, MRSA in the immediate patient environment, on both the bedrails and the cleaning wipes in the MRSA cohort cubicles in the orthopaedic unit. The extent of environmental contamination within MRSA cohort cubicles and the effectiveness of environmental disinfection in the hospital was assessed in order to evaluate current disinfection procedures and generate recommendations on the use of non-disposable wipes for the disinfection process. This study adopted a quasi-experimental design. The environmental disinfection procedures of eight MRSA-positive hospitalized patients in two orthopaedic wards were evaluated in the study. 56 samples were collected on 14 occasions over a 7-day period. A total of 56 pre- and post-disinfection samples from the bedrails as well as pre- and post-use wipes samples were collected. MRSA was isolated from 48/56 pre-disinfection bedrails, 19/56 post-disinfection bedrails, 29/56 pre-use wipes and 38/56 post-use wipes. Significant counts of MRSA were detected on the bedrails as well as on the wipes. Paired t-test was used to calculate differences in mean between counts on post- and pre-use wipes and post-and pre-disinfection bedrails. The p-values obtained were <0.001 for both samples which indicating that the pre- and post-intervention samples were significantly different from each other but disinfection was not totally effective as MRSA survived the process in several cases. The disinfection process of the patient environment reduced MRSA survival on bedrails from a mean of -0.70 log to -1.65 log. MRSA survival was also detected on the wipes after each wiping and the mean difference ranged from 0.13 to 0.42. In comparison with similar studies, the average baseline MRSA loads (4.4 cfu/cm² ) on the bedrails as well as those left on the bedrails (0.4 cfu/cm² ) after disinfection were low. The extent of environmental contamination observed was lower than in studies elsewhere but the disinfection process showed a similar effectiveness. However, there was no reference standard to interpret the MRSA counts on the wipes. Based on the results of MRSA counts on post-disinfection bedrails, the level of microbial contamination was within an acceptable level, indicating that a change from non-disposable wipe to disposable would not significantly alter the outcome. On the other hand, the effect of rinsing between wiping actions during the process was highlighted by the significant reduction of bacteria on the wipes. In light of the study results, the researcher offers the following recommendations to hospital cleansing teams; non-disposable wipes require rinsing thoroughly in disinfectant between patient areas. Patients under contact precautions should have separate individual sets of cleaning tools from other patients, for their sole use, by introducing colour-coded wipes for patient group segregation. The use of disposable wipes is recommended for outbreak control.

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