Warren Bobby G, Barrett Aaron, Graves Amanda, Fils-Aime Guerbine, Edelschick Jennifer, Cullinan Jolinda, McCottter Diandrea, Turner Nicholas A, Anderson Deverick J
Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.
Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, NC, USA.
Infect Control Hosp Epidemiol. 2024 Jul 26;45(10):1-6. doi: 10.1017/ice.2024.101.
Frequently used physical therapy (PT) equipment is difficult to disinfect due to equipment material and shape. The efficacy of standard disinfection of PT equipment is poorly understood.
We completed a 2-phase prospective microbiological analysis of fomites used in PT at our hospital from September 2022 to October 2023. For both phases, study fomites were obtained after usage and split into symmetrical halves for sampling. In phase 1, sides were sampled following standard disinfection. In phase 2, sides were randomized 1:1 to intervention or control. Samples were obtained before and after the intervention, a disinfection cabinet using Ultraviolet C (UV-C) and 6% nebulized hydrogen peroxide. We defined antimicrobial-resistant clinically important pathogens (AMR CIP) as methicillin-resistant staphylococcus aureus (MRSA), Vancomycin Resistant Enterococcus (VRE), and Multidrug resistant (MDR)-Gram-negatives and non-AMR CIP as methicillin-sensitive staphylococcus aureus (MSSA), Vancomycin sensitive Enterococcus (VSE), and Gram-negatives. Three assessments were made: 1) contamination following standard disinfection (phase 1), 2) contamination postintervention compared to no disinfection (phase 2) and, 3) contamination following standard disinfection compared to postintervention (phase 1 vs phase 2 intervention).
The median total colony-forming units (CFU) from 122 study fomite samples was 1,348 (IQR 398-2,365). At the sample level, 52(43%) and 15(12%) of samples harbored any clinically important pathogens (CIPs) or AMR CIPs, respectively. The median CFU was 0 (IQR 0-55) in the intervention group and 977 (409-2,547) in the control group ( < .00001).
Following standard disinfection, PT equipment remained heavily contaminated including AMR and non-AMR CIPs. Following the intervention, PT equipment was less contaminated and harbored no AMR CIPs compared to control sides supporting the efficacy of the intervention on difficult-to-disinfect PT fomites.
由于设备材料和形状的原因，常用的物理治疗（PT）设备难以进行消毒。人们对PT设备标准消毒的效果了解甚少。
我们于2022年9月至2023年10月对我院PT中使用的污染物进行了两阶段前瞻性微生物分析。在两个阶段中，研究污染物均在使用后获取，并分成对称的两半进行采样。在第1阶段，按照标准消毒对各半侧进行采样。在第2阶段，各半侧以1:1的比例随机分为干预组或对照组。在干预前后采集样本，干预使用紫外线C（UV-C）消毒柜和6%雾化过氧化氢。我们将耐抗菌药物的临床重要病原体（AMR CIP）定义为耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）和多重耐药（MDR）革兰氏阴性菌，将非AMR CIP定义为甲氧西林敏感金黄色葡萄球菌（MSSA）、万古霉素敏感肠球菌（VSE）和革兰氏阴性菌。进行了三项评估：1）标准消毒后的污染情况（第1阶段），2）干预后与未消毒相比的污染情况（第2阶段），以及3）标准消毒后与干预后相比的污染情况（第1阶段与第2阶段干预）。
122个研究污染物样本的总菌落形成单位（CFU）中位数为1348（IQR 398 - 2365）。在样本水平上，分别有52个（43%）和15个（12%）样本含有任何临床重要病原体（CIP）或AMR CIP。干预组的CFU中位数为0（IQR 0 - 55），对照组为977（409 - 2547）（P <.00001）。
标准消毒后，PT设备仍受到严重污染，包括AMR和非AMR CIP。干预后，与对照侧相比，PT设备污染较少，且未发现AMR CIP，这支持了该干预措施对难以消毒的PT污染物的有效性。
