Veille documentaire MTPH

Auteur     Aaron S Hess
Auteur     Michelle Shardell
Auteur     J Kristie Johnson
Auteur     Kerri A Thom
Auteur     Mary-Claire Roghmann
Auteur     Giora Netzer
Auteur     Sania Amr
Auteur     Daniel J Morgan
Auteur     Anthony D Harris
Résumé     Objective. To determine whether enhanced daily cleaning would reduce contamination of healthcare worker (HCW) gowns and gloves with methicillin-resistant Staphylococcus aureus (MRSA) or multidrug-resistant Acinetobacter baumannii (MDRAB). Design. A cluster-randomized controlled trial. Setting. Four intensive care units (ICUs) in an urban tertiary care hospital. Participants. ICU rooms occupied by patients colonized with MRSA or MDRAB. Intervention. Extra enhanced daily cleaning of ICU room surfaces frequently touched by HCWs. Results. A total of 4,444 cultures were collected from 132 rooms over 10 months. Using fluorescent dot markers at 2,199 surfaces, we found that 26% of surfaces in control rooms were cleaned and that 100% of surfaces in experimental rooms were cleaned ([Formula: see text]). The mean proportion of contaminated HCW gowns and gloves following routine care provision and before leaving the rooms of patients with MDRAB was 16% among control rooms and 12% among experimental rooms (relative risk, 0.77 [95% confidence interval, 0.28-2.11]; [Formula: see text]). For MRSA, the mean proportions were 22% and 19%, respectively (relative risk, 0.89 [95% confidence interval, 0.50-1.53]; [Formula: see text]). Discussion. Intense enhanced daily cleaning of ICU rooms occupied by patients colonized with MRSA or MDRAB was associated with a nonsignificant reduction in contamination of HCW gowns and gloves after routine patient care activities. Further research is needed to determine whether intense environmental cleaning will lead to significant reductions and fewer infections. Trial registration. ClinicalTrials.gov identifier: NCT01481935.
Publication     Infection control and hospital epidemiology: the official journal of the Society of Hospital Epidemiologists of America
Volume     34
Numéro     5
Pages     487-493
Date     May 2013