Hospital cleaning

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Abstract

The aim of this narrative review is to present up-to-date facts concerning hospital cleaning (HC). HC is essential in the prevention of healthcare associated infections (HAI). If a proper HC is followed by a proper use of disinfectants even the HAI caused by the most dangerous nosocomial pathogens like methicillin-resistant Staphylococcus aureus, vancomycin- resistant Enterococcus, carbapenem-resistant Pseudomonas aeruginosa and multidrug-resistant Acinetobacter baumannii may be stopped without closing the ward or placing the patients in isolation. Critical hospital surfaces that may be highly contaminated with pathogens include toilet seats and bowels, toilet flush handles, doorhandles, furniture, hospital equipment, linen, clothes, buttons, switches, computers, printers, shelves, cellphones, curtains, patient chairs, nurse call-buttons and bed rails. Hand-touch sites at bedside pose the highest risk of HAI for patients and these should be targeted with continuous and detail cleaning. The most used methods for the assessment of hospital cleanliness are visual inspection, aerobic colony counts, adenosine triphosphate (ATP) bioluminescence and fluorescent markers. Together with soaps and detergents the environmental-friendly disinfectants like hydrogen peroxide, high-pressure steam, electrolyzed water, ozone, probiotic cleaners and microfiber cloths have a priority in hospital cleaning. Recent advances in the methods of hospital cleaning together with the continuous education of cleaning staff and nurses significantly contribute to the prevention and control of hospital outbreaks.

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How long do nosocomial pathogens persist on inanimate surfaces? A systematic review

Axel Kramer, Ingeborg Schwebke, Günter Kampf (2006)

Background Inanimate surfaces have often been described as the source for outbreaks of nosocomial infections. The aim of this review is to summarize data on the persistence of different nosocomial pathogens on inanimate surfaces. Methods The literature was systematically reviewed in MedLine without language restrictions. In addition, cited articles in a report were assessed and standard textbooks on the topic were reviewed. All reports with experimental evidence on the duration of persistence of a nosocomial pathogen on any type of surface were included. Results Most gram-positive bacteria, such as Enterococcus spp. (including VRE), Staphylococcus aureus (including MRSA), or Streptococcus pyogenes, survive for months on dry surfaces. Many gram-negative species, such as Acinetobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Serratia marcescens, or Shigella spp., can also survive for months. A few others, such as Bordetella pertussis, Haemophilus influenzae, Proteus vulgaris, or Vibrio cholerae, however, persist only for days. Mycobacteria, including Mycobacterium tuberculosis, and spore-forming bacteria, including Clostridium difficile, can also survive for months on surfaces. Candida albicans as the most important nosocomial fungal pathogen can survive up to 4 months on surfaces. Persistence of other yeasts, such as Torulopsis glabrata, was described to be similar (5 months) or shorter (Candida parapsilosis, 14 days). Most viruses from the respiratory tract, such as corona, coxsackie, influenza, SARS or rhino virus, can persist on surfaces for a few days. Viruses from the gastrointestinal tract, such as astrovirus, HAV, polio- or rota virus, persist for approximately 2 months. Blood-borne viruses, such as HBV or HIV, can persist for more than one week. Herpes viruses, such as CMV or HSV type 1 and 2, have been shown to persist from only a few hours up to 7 days. Conclusion The most common nosocomial pathogens may well survive or persist on surfaces for months and can thereby be a continuous source of transmission if no regular preventive surface disinfection is performed.

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Pseudomonas aeruginosa: a formidable and ever-present adversary.

K.G. Kerr, A.M. Snelling (2009)

Pseudomonas aeruginosa is a versatile pathogen associated with a broad spectrum of infections in humans. In healthcare settings the bacterium is an important cause of infection in vulnerable individuals including those with burns or neutropenia or receiving intensive care. In these groups morbidity and mortality attributable to P. aeruginosa infection can be high. Management of infections is difficult as P. aeruginosa is inherently resistant to many antimicrobials. Furthermore, treatment is being rendered increasingly problematic due to the emergence and spread of resistance to the few agents that remain as therapeutic options. A notable recent development is the acquisition of carbapenemases by some strains of P. aeruginosa. Given these challenges, it would seem reasonable to identify strategies that would prevent acquisition of the bacterium by hospitalised patients. Environmental reservoirs of P. aeruginosa are readily identifiable, and there are numerous reports of outbreaks that have been attributed to an environmental source; however, the role of such sources in sporadic pseudomonal infection is less well understood. Nevertheless there is emerging evidence from prospective studies to suggest that environmental sources, especially water, may have significance in the epidemiology of sporadic P. aeruginosa infections in hospital settings, including intensive care units. A better understanding of the role of environmental reservoirs in pseudomonal infection will permit the development of new strategies and refinement of existing approaches to interrupt transmission from these sources to patients.

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Biosynthesis of silver nanoparticles from Staphylococcus aureus and its antimicrobial activity against MRSA and MRSE.

Anima Nanda, M Saravanan (2009)

Silver bionanoparticles (AgNPs) have been known to have inhibitory and bactericidal effects. Resistance to antimicrobial agents by pathogenic bacteria has emerged in recent years and is a major health problem. This report focuses on the synthesis of metallic bionanoparticles of silver using a reduction of aqueous Ag+ ion with the culture supernatants of Staphylococcus aureus. The bioreduction of the Ag+ ions in the solution was monitored in the aqueous component and the spectrum of the solution measured through ultraviolet-visible spectrophotometry and characterized by atomic force microscopy. The AgNPs were evaluated for their antimicrobial activities against different pathogenic organisms. The most sensitive antimicrobial activity has been observed against methicillin-resistant S. aureus followed by methicillin-resistant Staphylococcus epidermidis and Streptococcus pyogenes, whereas only moderate antimicrobial activity was seen against Salmonella typhi and Klebsiella pneumoniae.

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Goran Belojević: (View ORCID Profile)

Journal

Title: Annals of Nursing

Abbreviated Title: Ann Nursing

Publisher: Medika College for Vocational Studies in Healthcare, Belgrade

ISSN (Print): 2956-0179

ISSN (Electronic): 2956-0306

Publication date Created: 2022

Publication date (Print): 2022

Volume: 1

Issue: 1

Pages: 7-23

Article

DOI: 10.58424/annnurs.xrn.4vy.r4s

SO-VID: fdf7caa8-0e4a-4761-862e-7e35592cf648

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Hospital cleaning

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Most cited references 75

How long do nosocomial pathogens persist on inanimate surfaces? A systematic review

Pseudomonas aeruginosa: a formidable and ever-present adversary.

Biosynthesis of silver nanoparticles from Staphylococcus aureus and its antimicrobial activity against MRSA and MRSE.

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