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SYDNEY, AUSTRALIA – Sanitation staff cleaning hospital intensive care units (ICUs) might be overlooking an area that can harbor a multitude of dangerous bacteria: clinical workstations.
That’s according to a pilot study published recently in American Journal of Infection Control.
For the investigation, researchers from Western Sydney University in Australia employed three different sampling methods in a busy ICU to uncover where multidrug-resistant organisms (MDROs) might still be hiding after routine environmental cleaning.
“The location of MDROs within an ICU may be subject to patterns of localization and dispersion,” study authors explain. “The transfer of these MDROs away from the patient area and throughout the ICU is thought to occur largely via unwashed hands and gloved hands. High-touch objects (HTOs) are located throughout clinical areas and can provide a likely transit point for microbes owing to the frequency of hand touches.”
Tracing the steps of healthcare workers (HCWs) in between their workstations and patient bedsides and sampling commonly touched objects along the way for MDROs, the researchers confirmed that nine of 13 MDROs still lurking came from clinical workstations -- on chairs, clipboards, keyboards, telephones, and a computer mouse.
The study also found that using two commercially available adenosine triphosphate (ATP) bioluminometers was more than seven times as likely to positively identify MDROs as microbial swabbing –33.3% vs. 4.3%.
"In this pilot study, we found that many of the high touch objects from which MDROs were recovered were not items included in cleaning protocols," the researchers point out. "The findings of this study suggest the need to review the hygiene standards adopted in the clinical workspace, away from the immediate patient zones in busy ICUs, and indicate that ATP testing may help identify high touch objects with less than optimal cleanliness."
The study adds that specific MDRO locations were not limited to the immediate patient surroundings or to any specific HTO or type of surface. Still, the researchers note, “The use of ATP testing helped rapidly identify the soiled locations for MDRO sampling. The greatest density of positive MDRO locations was around and within the clinical staff work station.”