March 07, 2017
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Hospital floors a greater source of infection than previously thought

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The floors of patient rooms in hospitals are often contaminated with health-care associated pathogens, suggesting that hospital floors may pose a larger threat of infection than previously thought, according to a survey published in the American Journal of Infection Control.

Efforts to improve disinfection usually focus on surfaces that are frequently touched (eg, bed rails and call buttons),” Abhishek Deshpande, MD, PhD, of the Medicine Institute Center for Value Based Care, Cleveland Clinic, Cleveland, Ohio, and colleagues wrote. “Although health care facility floors are often heavily contaminated, limited attention has been paid to disinfection of floors because they are not frequently touched.”

The researchers conducted a survey of five Cleveland-area hospitals. Each hospital’s disinfectant routine consisted of having personnel clean high-touch surfaces in C. difficile infection (CDI) isolation rooms with bleach wipes. Hospital floors were cleaned with an ammonia-based solution after patient discharge, and were only cleaned upon admission if the floor was “visibly soiled.” Deshpande and colleagues took cultures from 1-foot-square areas from the patient floor adjacent to the bed and the adjoining bathroom floor, sampling a total of 318 sites in 159 rooms.

Contamination with C. difficile, vancomycin-resistant enterococci (VRE) and MRSA was common, Deshpande and colleagues reported. MRSA and VRE were more common in CDI isolation rooms than in non-CDI rooms (P < .05). C. difficile was identified equally in both CDI and non-CDI rooms (P = .6). The frequency of contamination was similar across all collection sites, the researchers wrote.

Rooms that had been cultured after post-discharge cleaning (n = 50) were less contaminated with MRSA and VRE than those cultured during the patient’s stay (n = 109) (13% vs. 35%; P < .001). These rooms were not significantly less contaminated with C. difficile, however (44% vs. 53%; P = .2).

“We found that floors in patient rooms were frequently contaminated with health care-associated pathogens and demonstrated the potential for indirect transfer of pathogens to hands from fomites placed on the floor,” the researchers wrote. “Further studies are needed to investigate the potential for contaminated hospital floors to contribute to pathogen transmission.” – by Andy Polhamus

Disclosure: Deshpande reports research grants from 3M, Clorox and Steris. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.