71 / 150
Results:
122 MRSA patients were treated according to the 5 day
protocol. In patients colonized in only one location (nose, throat or
perineum) (n = 35), the decolonization protocol proved to be effective
in 74.3% of cases. In patients colonized in multiple locations (n = 44)
and/or with risk factors (n = 56), the treatment was successful in
respectively 54.5% and 57.1% of the patients. Most patients (81.4%)
became negative after just one attempt. Overall, 67% of the carriers
remained negative up to one year of follow up.
Discussion and/or Conclusion(s):
The success rate of MRSA decolon-
ization is just below 70%, even with patients estimated to have a low
chance of success included. Therefore, a universal rather than a
targeted MRSA decolonization strategy seems to be justifiable.
ID: 4833
Are ATP and protein suitable tests for benchmarking cleaning of
surgical instruments?
Dayane Costa
1,2
, Lillian Kelly Lopes
3
, Roel Castilho
4
, Honghua Hu
5
,
Anaclara Tipple
3
, Karen Vickery
5
.
1
Surgical Infection Research Group,
Faculty of Medicine and Health Sciences, Macquarie University, Sydney,
Australia;
2
Faculty of Nursing, Federal University of Goias,
3
Faculty of
Nursing, Federal University of Goias, Goiania, Brazil;
4
Sterilizing Service
Unit, Macquarie University Hospital,
5
Surgical Infection Research Group,
Faculty of Medicine and Health Sciences, Macquarie University, Sydney,
Australia
Background:
Use of adenosine triphosphate (ATP) and protein tests
have increased in Central Supply Sterilizing Department, however,
its use is not completely standardized and requires a validation of
benchmark according to the instrument design.
Aim(s)/Objective(s):
To determine if Clean-Trace ATP and protein
(3M) are suitable tests for benchmarking cleaning of surgical
instruments.
Method(s):
Six orthopaedic flexible drill bits (FDB) were contaminated
with trypic soya broth containing 5% sheep blood and
Staphylococcus
aureus
(10
8
cells/mL), allowed to dry for 4 hours and subjected to pre-
rinsing, manual or automated cleaning. ATP present on the instrument
surface and lumen, surface protein (50 μg
–
qualitative test), and
bacterial contamination (Colony Forming Units) were determined
after each step. The experiment was repeated five times.
Results:
The protein test was insensitive failing to detect 40% of the
FDB subjected just to pre-rinsing required cleaning, presenting them
as clean or just requiring re-rinsing, despite ATP readings above 20,000
RLU. ATP levels and microbial load significantly decreased following
either manual or automatic cleaning (
P
< 0.001). The median values for
surface ATP were 10,780, 73 and 18 RLU for pre-rinsed, manually
cleaned and automatically cleaned instruments, respectively. Similar
results were obtained for luminal ATP. The microbial load on pre-
rinsed instruments was Log
10
7.8492 which decreased 3 logs with
manual cleaning, and automatic cleaning removed all microbial
contamination (>7.8 log
10
reduction).
Discussion and/or Conclusion(s):
The protein test used is unsuitable
for point-of-use testing to determine if instruments are clean. ATP
demonstrated suitability for point-of-use test, however further
analysis of RLU variability is needed to validate a benchmark.
ID: 4852
How are Italy
’
s bone marrow transplant units decontaminated in
case of multi-drug resistant organisms? National survey by the
Nurses
’
Group of GITMO
Iris Agreiter
1
, Laura Orlando
2
, Gianpaolo Gargiulo
3
.
1
Division of
Haematology and BMT Centre, SanMaurizio, Bolzano,
2
Division of Clinical
Haemato-Oncology, European Institute of Oncology, Milano,
3
Division of
Clinical Haemato-Oncology, AOU Federico II, Napoli
Background:
Infections by multi-drug resistant organisms (MDRO)
represent a huge problem in Bone Marrow Transplant (BMT) units and
decontamination has turned to an actual topic.
Aim(s)/Objective(s):
The Board of Nursing Referents Section of the
Scientific Society
“
Italian Group of Bone Marrow Transplant
”
(GITMO)
has the aim to detect and improve hidden procedures of daily hospital
routine.
Method(s):
After a literature review, a questionnaire composed by 72
questions was sent to all 100 Italian BMT centres. From 21st February
until 31st March 2016, the principal BMT nurse of each centre filled
out the questionnaire on a Google Drive platform. The main domains
were six: infection control, screening, isolation, decontamination,
collaboration and communication.
Results:
Seventy-two centres divided into 50 adults, 14 paediatrics
and 8 mixed departments, answered to the questionnaire. Forty-eight
units are composed by a BMT centre and a haematology division, 24
are only BMT centres. Patient
’
s rooms colonised by MDRO are cleaned
twice a day in 87% of cases and left as last room to clean in 92% of units.
Cleaning personnel gets in 76% of centres a specific education on
MDRO decontamination and is in 91% of the units throughout
composed by the same cleaners. Microbiological controls after final
decontamination take place in 57% of BMT departments. Particle
count, plates and swabs are the most common procedures to control
the effectiveness of decontamination.
Discussion and/or Conclusion(s):
The national survey gives a
snapshot of the current situation in Italy. Many procedures could be
improved and standardised in order to enfeeble MDRO in BMT units.
ID: 4912
Evaluation of disposable pre-impregnated wipes versus a standard
two-step protocol for cleaning and disinfection of high-touch
surfaces in intensive care
Beatrice Casini
1
, Anna Righi
2
, Nunzio De Feo
3
, Serena Giorgi
2
,
Lavinia Zezza
2
, Enrico Tagliaferri
4
, Paolo Malacarne
3
,
Gaetano Privitera
2
.
1
Department Translational Research, University of
Pisa, N.T.M.S.,
2
Department of Translational Research, University of Pisa,
N. T.M.S.,
3
Anesthesia and Intensive Care Unit PS, University Hospital,
4
Infectious Disease Unit, University Hospital, Pisa, Italy
Aim(s)/Objective(s):
To evaluate the effectiveness of pre-impregnated
wipes in reducing environmental bacterial burden when compared to
the current standard protocol (SP).
Method(s):
High-touch surfaces in a 12-bed Intensive Care Unit were
cleaned and disinfected either by the daily standard two-step protocol,
application of an alcohol-based detergent Keradet (Kiehl), followed
by a chlorine-based disinfectant Antisapril 2% (Angelini), or by using
disposable wipes impregnated with quaternary ammonium com-
pounds/Biguanide (Clinell Universal Wipes, GAMA).
Effectiveness in reducing microbial burden of high touch near-patient
surfaces was assessed by a contact plate method on five sites
immediately pre- procedure and post- at 0.5, 2.5, 4.5 and 6.5 hours.
The study was repeated five times over three months, sampling 11
beds for each protocol (560 sampling sites).
Results:
Pre-impregnated wipes demonstrated a decrease in mean
Total Bacterial Count (TBC) from 43 to 16 CFU/24 cm
2
(63.9%) after 0.5
hours vs. a reduction from 27 to 16 CFU/24 cm
2
(40.3%) for the SP. In
subsequent 2.5, 4.5 and 6.5-hour tests, mean TBCs decreased
respectively by 64.1%, 65.6% and 74.1% with disposable wipes, while
for SP methods, TBCs showed increases of 8.3%, 20.7% and 24.3%.
According to the Italian hygiene standard (ISPESL, 2009), when using
pre-impregnated wipes 14 of 180 sites of sites showed TBC >50 CFU/
24 cm
2
(Hygiene Failures) whereas for SP 32 of 176 sites were classed
as failed (Chi squared, p < 0.05).
Discussion and/or Conclusion(s):
Disposable wipes used on near-
patient inanimate surfaces provide a more effective alternative to the
usual two-step procedures, considering the potential residual activity.
ID: 4952
Dry biofilms: implications in clinical environmental disinfection
Jawal Said
1
, Tamara Perez Outeiral
2
, Jean-Yves Maillard
2
,
Martin Kiernan
3
.
1
Cardiff University/GAMA Healthcare Ltd.,
2
Cardiff
University,
3
University of West London
Background:
Clinical surfaces may become contaminated with
microorganisms. Cleaning and disinfection are crucial interventions
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S66