the patient’s endogenous flora is
introduction responsible for 40-60%
Cross-infection through the
hands of healthcare personnel
Contaminated surfaces in hospital rooms have been found to accounts for around 20-40%.
play a significant role in transmitting healthcare-associated Changes in the flora
pathogens. due to antibiotic use
Pathogens like MRSA, VRE, Clostridium difficile, contribute to about
Acinetobacter spp., and norovirus can survive on surfaces and 20-25%
contribute to the spread of infections. Better cleaning of rooms
The remaining
and improved disinfection methods, like vaporized hydrogen 20% is attributed
peroxide, can help reduce infection rates. It's important to take to other factors.
these measures seriously to protect patients and prevent the
spreading of infections.
the ways of transmission of healthcare-associated infections
◦ The transfer of pathogens from a colonized or infected patient to a susceptible patient can occur through
various pathways, with the most common being via the hands of healthcare personnel. However,
contaminated hospital surfaces, medical equipment, water, and even air can also play a role in the
transmission of pathogens.
◦ Researchers have developed models to understand these transmission pathways and have used them to develop
interventions aimed at disrupting transmission.
◦ In the next chapter , we'll focus on recent literature that highlights the significance of surface contamination in
hospitals for patient-to-patient transmission of pathogens, as well as scientifically proven interventions to
reduce such transmission.
◦
CONTAMINATION OF SURFACES IN THE HOSPITAL ENVIRONMENT
◦ Hospital surfaces can be contaminated with various pathogens like MRSA, VRE, Pseudomonas spp.,
Acinetobacter spp., and norovirus, which can survive for days to weeks. C. difficile spores can even survive
for months.
◦ Studies show that surfaces in patient rooms with infected or colonized patients are frequently contaminated. The
percentage of contaminated surfaces varies depending on the pathogen.
◦
• The range from 1% to • The range from 60%
27% in regular to 70% in the
hospital wards rooms
• The range is 64% in • The range from 36%
burn units with
MRSA patients
to 58% of chairs
and couches used
For For VRE
MRSA
Acinetob For C.
acter spp difficile
• The range from
• 29% to 75% of
• The range from environmental
3% to 50%. contamination in
rooms
ROLE OF THE CONTAMINATED ENVIRONMENT IN TRANSIENT HAND/ GLOVE
CONTAMINATION OF HEALTHCARE PERSONNEL
Healthcare personnel frequently encounter contaminated environmental surfaces in patient rooms, leading to
potential glove and hand contamination.
Studies have shown that healthcare personnel can get their hands contaminated with MRSA whether they
directly touch a patient or only touch contaminated surfaces.
The risk of contamination is higher when there are positive environmental cultures, indicating a higher level of
contamination in the environment.
SURFACE CONTAMINATION FOLLOWING DISINFECTION
◦Different methods of assessing cleanliness have been used, such as visual inspection, ATPase testing, fluorescent dye,
and aerobic plate counts. Unfortunately, these studies have found that less than 50% of room surfaces are clean. As a
result, many hospital surfaces remain contaminated with harmful pathogens.
The commonly used surface disinfectants in hospitals, such as phenols and quaternary ammonium compounds are not
effective against spore-forming pathogens.
Fortunately, there are now multiple surface disinfectants registered by the US Environmental Protection Agency (EPA) as
effective against C. difficile and norovirus.
◦there is a huge risk due to inadequate terminal disinfection because when a patient is admitted to a room where the
previous patient was colonized or infected with pathogens like MRSA, VRE, C. difficile, or multidrug-resistant
Acinetobacter spp. or Pseudomonas, there is an increased risk of the next patient getting colonized or infected with the
same pathogen.
It highlights the importance of proper terminal disinfection to prevent the transmission of these harmful pathogens.
◦
PREVENTING TRANSMISSION OF NOSOCOMIAL PATHOGENS
DUE TO CONTAMINATED SURFACES
here are three main methods to prevent the transmission of healthcare-associated pathogens through contaminated
surfaces.
◦The first is to improve the cleaning and disinfection of room surfaces, making sure they are thoroughly cleaned
to reduce the risk of transmission.
◦ The second method involves using "no touch" methods for terminal room disinfection, such as devices that
generate ultraviolet light or hydrogen peroxide. These methods can help ensure a more effective and thorough
disinfection process.
◦Lastly, there are "self-disinfecting" surfaces that have been developed to reduce the presence of pathogens on
environmental surfaces. These surfaces have antimicrobial properties and can help minimize the bioburden
◦
