Yale-New Haven Hospital, New Haven, Connecticut.
Yale University School of Medicine, New Haven, Connecticut [Present affiliation: J.M. Boyce Consulting, Middletown, CT (J.M.B.)].
Infect Control Hosp Epidemiol. 2022 Sep;43(9):1142-1146. doi: 10.1017/ice.2021.349. Epub 2021 Aug 16.
Estimated levels of microbial burden on hospital environmental surfaces vary substantially among published studies. Cultures obtained during a cluster-controlled crossover trial of a quaternary ammonium (Quat) disinfectant versus an improved hydrogen peroxide (IHP) disinfectant provided additional data on the amount of microbial burden on selected surfaces.
RODAC plates containing D/E neutralizing agar were used to sample a convenience sample of 5-8 high-touch surfaces in patient rooms on 2 medical wards, an intensive care unit, and a step-down unit at a large hospital. Before routine daily cleaning, samples were obtained in varying rooms over an 11-month period. RODAC plates (1 per surface sampled) were incubated for 72 hours, and aerobic colony counts per plate (ACCs) were determined. Statistical analysis was used to determine the potential impact on ACCs of study period, cleaning compliance rate, disinfectant used, ward, surface sampled, and isolation room status.
Overall, 590 cultures were obtained on Quat wards and 589 on IHP wards. Multivariable regression analysis revealed that mean ACCs differed significantly by site ( < .001), type of ward ( < .001), isolation room status ( = .039), and study period ( = .036). The highest mean ACCs per RODAC plate were on toilet seats (112.8), bedside rails (92.0), and bathroom grab bars (79.5).
The combination of factors analyzed revealed that estimating microbial burden is complex and is affected by multiple factors. Additional studies should evaluate individual sites, ward types, cleaning and disinfection practices, and isolation room status.
发表的研究中，医院环境表面微生物负荷的估计水平差异很大。在一项季铵盐（Quat）消毒剂与改良过氧化氢（IHP）消毒剂的集群对照交叉试验中获得的培养物提供了有关选定表面微生物负荷量的额外数据。
使用含有 D/E 中和琼脂的 RODAC 平板对大型医院的 2 个医疗病房、1 个重症监护病房和 1 个降阶梯病房中 5-8 个高接触表面进行了便利抽样。在常规日常清洁之前，在 11 个月的时间内，在不同的房间中进行了采样。RODAC 平板（每个采样表面 1 个）孵育 72 小时，确定每个平板的需氧菌落计数（ACCs）。统计分析用于确定研究期间、清洁合规率、使用的消毒剂、病房、采样表面和隔离室状态对 ACCs 的潜在影响。
总体而言，Quat 病房共获得 590 个培养物，IHP 病房共获得 589 个培养物。多变量回归分析显示，平均 ACCs 因部位（<0.001）、病房类型（<0.001）、隔离室状态（=0.039）和研究期间（=0.036）差异有统计学意义。每个 RODAC 平板的平均 ACCs 最高的部位是马桶座（112.8）、床边栏杆（92.0）和浴室抓杆（79.5）。
分析的组合因素表明，估计微生物负荷是复杂的，受多种因素影响。应进一步研究评估个别部位、病房类型、清洁和消毒实践以及隔离室状态。
