Improving environmental hygiene in 27 intensive care units to decrease multidrug-resistant bacterial transmission*

  title={Improving environmental hygiene in 27 intensive care units to decrease multidrug-resistant bacterial transmission*},
  author={Philip C Carling and Michael F. Parry and Lou Ann Bruno-Murtha and Brian Dick},
  journal={Critical Care Medicine},
Objective:To determine the thoroughness of terminal disinfection and cleaning of patient rooms in hospital intensive care units and to assess the value of a structured intervention program to improve the quality of cleaning as a means of reducing environmental transmission of multidrug-resistant organisms within the intensive care unit. Design:Prospective, multicenter, and pre- and postinterventional study. Setting:Intensive care unit rooms in 27 acute care hospitals. Hospitals ranged in size… 

A Randomized Controlled Trial of Enhanced Cleaning to Reduce Contamination of Healthcare Worker Gowns and Gloves with Multidrug-Resistant Bacteria

Intense enhanced daily cleaning of ICU rooms occupied by patients colonized with MRSA or MDRAB was associated with a nonsignificant reduction in contamination of HCW gowns and gloves after routine patient care activities.

Environmental cleaning and disinfection: Sustaining changed practice and improving quality in the community hospital

Improvements in environmental cleaning were associated with dramatic reductions in HAI rates over the 10-year period and have been sustained to the present.

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants.

Enhanced intensive care unit cleaning using the intervention methods may reduce MRSA and VRE transmission and eliminate the risk of MRSA acquisition due to an MRSA-positive prior room occupant.


In a hospital rooms, patient environmental surfaces can be a vehicle for the transmission of multidrug-resistant (MDR) bacterial agents that cause healthcare-associated infections.

Improving hospital environmental hygiene with the use of a targeted multi-modal bundle strategy

What Healthcare Workers Should Know about Environmental Bacterial Contamination in the Intensive Care Unit

Healthcare workers should be aware of the role of environmental contamination in the ICU and consider it in the broader perspective of infection control measures and stewardship initiatives.

Cleaning Hospital Room Surfaces to Prevent Health Care-Associated Infections: A Technical Brief.

The evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness, is described.

Efficiency of hydrogen peroxide in improving disinfection of ICU rooms

H 2O2 treatment is efficient in reducing MDRO contaminated rooms in the ICU, and the residual concentration of H2O2 appears to be higher using aHPP, compared with HPV.



Improving Cleaning of the Environment Surrounding Patients in 36 Acute Care Hospitals

Significant improvements in disinfection cleaning can be achieved in most hospitals by the use of a structured approach that incorporates a simple, highly objective surface targeting method, repeated performance feedback to environmental services personnel, and administrative interventions.

Reduction in acquisition of vancomycin-resistant enterococcus after enforcement of routine environmental cleaning measures.

Investigating the effects of improved environmental cleaning with and without promotion of hand hygiene adherence on the spread of vancomycin-resistant enterococci as a marker organism found decreased in period 2 and remained low thereafter, suggesting decreasing environmental contamination may help to control thespread of some antibiotic-resistant bacteria in hospitals.

Identifying Opportunities to Enhance Environmental Cleaning in 23 Acute Care Hospitals

Significant opportunities in all participating hospitals to improve the cleaning of frequently touched objects in the patient's immediate environment are identified to improve cleaning and disinfection practices in healthcare institutions.

Impact of an Environmental Cleaning Intervention on the Presence of Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci on Surfaces in Intensive Care Unit Rooms

Increasing the volume of disinfectant applied to environmental surfaces, providing education for Environmental Services staff, and instituting feedback with a black-light marker improved cleaning and reduced the frequency of MRSA and VRE contamination.

Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study

Molecular epidemiological methods supported the possibility that patients acquired meticillin-resistant S. aureus from environmental sources, and the potential impact of enhanced hygienic cleaning as a component in the control of hospital-acquired infection was evaluated.

Impact of routine intensive care unit surveillance cultures and resultant barrier precautions on hospital-wide methicillin-resistant Staphylococcus aureus bacteremia.

  • Susan S. HuangD. Yokoe R. Platt
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2006
Routine surveillance for MRSA in ICUs allowed earlier initiation of contact isolation precautions and was associated with large and statistically significant reductions in the incidence of MRSA bacteremia in the ICUs and hospital wide.

Antibiotic Exposure and Room Contamination Among Patients Colonized With Vancomycin-Resistant Enterococci

Room contamination with VRE was associated with increased mean colonization pressure in the ICU and diarrhea in the VRE-colonized patient, whereas no use of any antibiotics during VRE colonization was protective.

Reduction of Clostridium Difficile and vancomycin-resistant Enterococcus contamination of environmental surfaces after an intervention to improve cleaning methods

These findings provide additional evidence that simple educational interventions directed at housekeeping staff can result in improved decontamination of environmental surfaces.

Impact of Hydrogen Peroxide Vapor Room Decontamination on Clostridium difficile Environmental Contamination and Transmission in a Healthcare Setting

HPV decontamination was efficacious in eradicating C. difficile from contaminated surfaces and the incidence of nosocomial CDAD was significantly lower during the intervention period than during the preintervention period.