There ’ s never been any paper of any significance that I ’ ve seen that would dissuade us from the basic premise that the role of the environment is significant and that can be addressed in a more objective way even than hand hygiene can , because you can objectively evaluate cleaning and disinfection practice so easily .” collateral pathogen elimination through these C . diff elimination strategies .
“ I think it is likely that there is a significant collateral benefit to the approach we presented in mitigating HO-CDI in terms of such a program also impacting the transmission of many hospital-associated pathogens , since asymptomatic colonized patients remain colonized for months to years . These resistant organisms , are then shed asymptomatically shed into the patient-zone environment where they are spread via surfaces and hands . Recent studies have shown that such shedding is greatly increased when a colonized patient is treated with almost any antibiotic . Given the fact that more than half of hospitalized patients receive antibiotics , I think we ’ re going to learn a lot more about the magnitude of this phenomenon through the rapidly evolving science of genomic epidemiology , as we discussed in our review paper .”
As Carling , et al . ( 2023 ) explain , “ Over the past several years there has been increasing documentation of the potential and actual role of surfaces in the near patient environment being relevant in HAI epidemiology . Patient-zone environmental surfaces are frequently contaminated with a wide range of healthcare-acquired pathogens . While the frequency of contamination is greatest close to patients , genomic epidemiology has confirmed more distance spread .
While documenting high-level CRE contamination ( 88 percent of surfaces ) associated with colonized patients , the study by Shams also found that 80 percent of all contamination was associated with 20 percent of colonized patients which they characterized as super shedders . Although many of the HAI-associated pathogens are effectively killed by quaternary-ammonium compounds , or accelerated hydrogen peroxide , the use of hydrogen peroxide-peroxyacetic acid chemistries for CD mitigation would allow for highly effective disinfection of surfaces harboring Candida auris , norovirus and quaternary-ammonium resistant A . baumannii .”
Carling says that he and his co-authors endeavored to summarize the support for how to mitigate HO-CDI transmission in acute-care hospitals based on all the research over the past 25 years .
“ It ’ s becoming a more objective , consistent message that the environment is key in preventing transmission of essentially all healthcare-acquired pathogens , something what we ’ ve believed all along , and we ’ ve never retreated from this belief ,” Carling says . “ There ’ s never been any paper of any significance that I ’ ve seen that would dissuade us from the basic premise that the role of the environment is significant and that can be addressed in a more objective way even than hand hygiene can , because you can objectively evaluate cleaning and disinfection practice so easily .”