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A. baumannii disinfection not always adequate

Sunday December 2, 2012
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Current hospital cleaning protocol may be inadequate to rid patient rooms of multidrug-resistant Acinetobacter baumannii, according to a study.

A team of researchers from the University of Maryland School of Medicine collected 487 cultures from 32 hospital rooms occupied by just-discharged patients with a known history of multidrug-resistant A. baumannii both before and after terminal cleaning of the rooms. Over half of the rooms positive for the A. baumannii bacteria prior to cleaning remained contaminated after terminal cleaning had occurred.

Fifteen rooms (46.9%) and 41 sites (15.3%) tested positive for multidrug-resistant A. baumannii before cleaning. Post-cleaning, eight rooms (25%) and 12 sites (5.5%) still tested positive for the pathogen. Sites with post-cleaning contamination included the floor (12.5%), call button (10%), door handle (9.4%) bedside table (7.4%) and supply cart (3.8%).

"Persistent room contamination serves as a potential reservoir for transmission and colonization of future room occupants," the authors wrote in the December issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology.

"Current cleaning techniques in terms of products used or thoroughness of cleaning may not be adequate in the decontamination of pathogens."

Acinetobacter baumannii is a type of bacteria that has become increasingly prevalent in healthcare facilities and is resistant to most antibiotics. Infections from this pathogen primarily occur in very ill, wounded or immunocompromised patients. The germ can remain on wet or dry surfaces for longer than most other organisms, making it harder to eradicate.

"This study shows how difficult it is to ensure removal of particularly resistant organisms from the environment even upon thorough discharge cleaning," Anthony D. Harris, MD, MPH, the study’s lead author and a professor of epidemiology and public health at the University of Maryland School of Medicine, said in a news release.

The study is available at www.ajicjournal.org/article/S0196-6553%2812%2901020-6/fulltext.

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