cover story
Environmental Hygiene : Trends from the Medical Literature
By Kelly M . Pyrek
Environmental hygiene is more critical than ever before as healthcare facilities continue to battle COVID-19 transmission . As Fakih , et al . ( 2020 ) remind us , “ The approach to curbing further transmission of COVID-19 within communities focuses on the institution of measures to detect and isolate those infected , to practice point source control , to reduce environmental contamination , and to optimize engineering controls … Environmental cleaning reduces the chance for persons to contact contaminated surfaces , and engineering control through deploying spatial separation and reducing crowding will lessen the chances of exposure to the pathogen .”
Let us review some of the recent findings from the medical literature that explore timely and topical environmental hygiene-related imperatives .
Moore , et al . ( 2020 ) investigated the presence of SARS-CoV-2 in the air and on environmental surfaces around hospitalized patients , with and without respiratory symptoms . Environmental sampling was conducted within eight hospitals in England during the first wave of the COVID-19 outbreak . Samples were analzsed using reverse transcription polymerase chain reaction ( RT-PCR ) and virus isolation assays . The researchers detected SARS-CoV-2 RNA on 30 ( 8.9 percent ) of 336 environmental surfaces . Ct values ranged from 28 · 8 to 39 · 1 equating to 2 · 2 x 105 to 59 genomic copies / swab . They say that concomitant bacterial counts were low , suggesting the cleaning performed by nursing and domestic staff across all eight hospitals was effective . SARS-CoV-2 RNA was detected in four of 55 air samples taken < 1 m from four different patients . In all cases , the concentration of viral RNA was low and ranged from < 10 to 460 genomic copies per m3 of air . Infectious virus was not recovered from any of the PCR positive samples analyzed . The researchers concluded that , “ Effective cleaning can reduce the risk of fomite ( contact ) transmission but some surface types may facilitate the survival , persistence and / or dispersal of SARS-CoV-2 . The presence of low or undetectable concentrations of viral RNA in the air supports current guidance on the use of specific PPE ensembles for aerosol and non-aerosol generating procedures .”
•••
The floors of hospital rooms are quickly and frequently contaminated with antibiotic-resistant bacteria within hours of patient admission , creating a route of transfer of potentially dangerous organisms to patients , according to a recent study .
“ If bacteria stayed on floors this wouldn ’ t matter , but we ’ re seeing clear evidence that these organisms are transferred to patients , despite our current control efforts ,” says Curtis Donskey , MD , senior author of the study and hospital epidemiologist at the Cleveland VA Medical Center . “ Hand hygiene is critical , but we need to develop practical approaches to reduce underappreciated sources of pathogens to protect patients .”
•
The floors of hospital rooms are quickly and frequently contaminated with antibioticresistant bacteria within hours of patient admission , creating a route of transfer of potentially dangerous organisms to patients , according to a recent study .