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Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

Published online by Cambridge University Press:  12 January 2021

Sarah N. Redmond ,
Basya S. Pearlmutter ,
Yilen K. Ng-Wong ,
Heba Alhmidi ,
Jennifer L. Cadnum ,
Sandra Y. Silva ,
Brigid M. Wilson  and
Curtis J. Donskey
Sarah N. Redmond
Affiliation:
Case Western Reserve University School of Medicine, Cleveland, Ohio
Basya S. Pearlmutter
Affiliation:
Research Service, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio
Yilen K. Ng-Wong
Affiliation:
Research Service, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio
Heba Alhmidi
Affiliation:
Research Service, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio
Jennifer L. Cadnum
Affiliation:
Research Service, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio
Sandra Y. Silva
Affiliation:
Clinical and Translational Science Program, School of Medicine, Case Western Reserve University
Brigid M. Wilson
Affiliation:
Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
Curtis J. Donskey*
Affiliation:
Case Western Reserve University School of Medicine, Cleveland, Ohio Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
*
Author for correspondence: Curtis J. Donskey, E-mail: Curtis.Donskey@va.gov
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Abstract

Objective:

To investigate the timing and routes of contamination of the rooms of patients newly admitted to the hospital.

Design:

Observational cohort study and simulations of pathogen transfer.

Setting:

A Veterans’ Affairs hospital.

Participants:

Patients newly admitted to the hospital with no known carriage of healthcare-associated pathogens.

Methods:

Interactions between the participants and personnel or portable equipment were observed, and cultures of high-touch surfaces, floors, bedding, and patients’ socks and skin were collected for up to 4 days. Cultures were processed for Clostridioides difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Simulations were conducted with bacteriophage MS2 to assess plausibility of transfer from contaminated floors to high-touch surfaces and to assess the effectiveness of wearing slippers in reducing transfer.

Results:

Environmental cultures became positive for at least 1 pathogen in 10 (59%) of the 17 rooms, with cultures positive for MRSA, C. difficile, and VRE in the rooms of 10 (59%), 2 (12%), and 2 (12%) participants, respectively. For all 14 instances of pathogen detection, the initial site of recovery was the floor followed in a subset of patients by detection on sock bottoms, bedding, and high-touch surfaces. In simulations, wearing slippers over hospital socks dramatically reduced transfer of bacteriophage MS2 from the floor to hands and to high-touch surfaces.

Conclusions:

Floors may be an underappreciated source of pathogen dissemination in healthcare facilities. Simple interventions such as having patients wear slippers could potentially reduce the risk for transfer of pathogens from floors to hands and high-touch surfaces.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 9 , September 2021 , pp. 1076 - 1081
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Creative Commons
This work is classified, for copyright purposes, as a work of the U.S. Government and is not subject to copyright protection within the United States.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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