with the key organisms being MRSA, VRE, C. difficile, Acinetobacter, norovirus and C. auris.”

To connect these dots, Weber dove into the medical literature, pointing to a systematic review by Gastmeier, et al.( 2006), which examined 1,561 records of hospital-acquired outbreaks published in the medical literature and found that the most frequent outbreak sources were for specific pathogens; overall, in 37.1 percent no source was identified; the main sources identified were index patients( 40.3 percent), equipment and devices( 21.1 percent), the environment( 19.3 percent) and personnel( 15.8 percent).

He next addressed a review by Mitchell published in Infection, Disease and Health which reported that from 28,299 patients who were admitted into a room where the prior-room occupant had any of the organisms of interest, 651 were shown to acquire the same species of organism. In contrast, 981,865 patients admitted to a room where the prior occupant did NOT have an organism of interest, 3,818 acquired an organism. The conclusion was that risk of pathogen acquisition appears to remain high, supporting the need for continued investment in this area.

“ There are many methods of decontaminating the environment,” Weber said.

“ We obviously use disinfectant liquids most commonly, usually combined-- at least in the U. S.-- with wipes so you get physical removal and the activity of the disinfectant. More recently, we have been using UV-C light for terminal room disinfection. You can use high-intensity light, self-sanitizing surfaces, microbicide-coated, microbicide-impregnated, gas, mist or foam, photosensitized, portable steam, etc. We know that rooms become rapidly decontaminated, and the Holy Grail is either a persistent antimicrobial coating or a continuous room disinfection. There are many disinfection systems for entire rooms and room surfaces, continuous room disinfection technologies, self-disinfecting surfaces and other technologies which represent a very large areas of research, and none of these risk research techniques are ideal.”

In the study undertaken by Weber, et al.( 2023), multiple papers were identified including clinical trials of UV room disinfection devices, HP room disinfection systems, handheld UV devices, and copper-impregnated or coated surfaces. Most but not all clinical trials of UV devices and HP systems for terminal disinfection demonstrated a reduction of colonization / infection in patients subsequently housed in the room. Copper-coated surfaces were the only

‘ self-disinfecting’ technology evaluated by clinical trials. Results of these clinical trials were mixed. The authors noted,“ Almost all clinical trials reviewed used a weak design( e. g., before-after) and failed to assess potential confounders( e. g., compliance with hand hygiene and environmental cleaning). The evidence is strong enough to recommend the use of a‘ no-touch’ method as an adjunct for outbreak control, mitigation strategy for high-consequence pathogens( e. g., Candida auris or Ebola), or when there are excessive endemic rates of multidrug-resistant organisms.”

Weber also discussed the study by Sansom, et al.( 2024) who conducted a prospective multicenter study of environmental contamination associated with C. auris colonization at six ventilator-capable skilled nursing facilities and one acute-care hospital in Illinois and California. Known C. auris carriers were sampled at five body sites followed by sampling of nearby room surfaces before disinfection and at 0, 4, 8, and 12 hours after disinfection. Samples were cultured for C. auris and bacterial multidrug-resistant organisms( MDROs). Odds of surface contamination after disinfection were analyzed using multi-level generalized estimating equations. Among 41 known C. auris carriers, colonization was detected most

The Infection Prevention Exchange

By MD-Medical Data Quality & Safety Advisors, LLC

The IPEX Bundle

• Data

• Process Improvement

• Technology • Artificial Intelligence

Patient & Staff Safety

Patient Satisfaction Scores improved LeapFrog Scores improved

Financial & Operational Efficiencies 50-75 % Reductions in cost of infection

HEALTHCARE-ASSOCIATED INFECTIONS

Contact Tracing

50-75 % Reductions in infections

Inquiries: Medicaldatamanagement @ gmail. com