Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ.
Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ.
Am J Infect Control. 2019 Feb;47(2):128-132. doi: 10.1016/j.ajic.2018.06.017. Epub 2018 Sep 5.
Halting the spread of harmful microbes requires an understanding of their transmission via hands and fomites. Previous studies explored acute and long-term care environments but not outpatient clinics. Objectives of this study were to track microbial movement throughout an outpatient clinic and evaluate the impact of a disinfectant spray intervention targeting high-touch point surfaces.
At the start of the clinic day, a harmless viral tracer was placed onto 2 fomites: a patient room door handle and front desk pen. Patient care, cleaning, and hand hygiene practices continued as usual. Facility fomites (n = 19), staff hands (n = 4), and patient hands (n = 3-4) were sampled after 2, 3.5, and 6 hours. Tracer concentrations at baseline (before intervention) were evaluated 6 hours after seeding. For the intervention trials, high-touch surfaces were cleaned 4 hours after seeding with an ethanol-based disinfectant and sampled 2 hours after cleaning.
At 2, 3.5, and 6 hours after seeding, virus was detected on all surfaces and hands sampled, with examination room door handles and nurses' station chair arms yielding the highest concentrations. Virus concentrations decreased by 94.1% after the disinfectant spray intervention (P = .001).
Microbes spread quickly in an outpatient clinic, reaching maximum contamination levels 2 hours after inoculation, with the highest contamination on examination room door handles and nurses' station chairs. This study emphasizes the importance of targeted disinfection of high-touch surfaces.
阻止有害微生物的传播需要了解它们通过手和污染物的传播。以前的研究探讨了急性和长期护理环境，但没有探讨门诊诊所。本研究的目的是跟踪门诊诊所中的微生物运动，并评估针对高接触点表面的消毒剂喷雾干预的效果。
在诊所开始时，将无害病毒示踪剂放在 2 个污染物上：一个病房门把和前台笔。照常进行患者护理、清洁和手部卫生操作。在 2、3.5 和 6 小时后对设施污染物（n=19）、员工手（n=4）和患者手（n=3-4）进行采样。在播种前 6 小时评估基线（干预前）的示踪剂浓度。对于干预试验，在播种后 4 小时用乙醇基消毒剂清洁高接触表面，并在清洁后 2 小时进行采样。
播种后 2、3.5 和 6 小时，所有采样的表面和手上都检测到病毒，检查室门把手和护士站椅子扶手的浓度最高。消毒剂喷雾干预后病毒浓度下降 94.1%（P=0.001）。
微生物在门诊诊所中传播迅速，在接种后 2 小时达到最大污染水平，检查室门把手和护士站椅子上的污染最严重。本研究强调了对高接触点表面进行有针对性消毒的重要性。
