title: Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination.
abstract: The hospital environment can sometimes harbour methicillin-resistant Staphylococcus aureus (MRSA) but is not generally regarded as a major source of MRSA infection. We conducted a prospective study in surgical wards of a London teaching hospital affected by MRSA, and compared the effectiveness of standard cleaning with a new method of hydrogen peroxide vapour decontamination. MRSA contamination, measured by surface swabbing was compared before and after terminal cleaning that complied with UK national standards, or hydrogen peroxide vapour decontamination. All isolation rooms, ward bays and bathrooms tested were contaminated with MRSA and several antibiogram types were identified. MRSA was common in sites that might transfer organisms to the hands of staff and was isolated from areas and bed frames used by non-MRSA patients. Seventy-four percent of 359 swabs taken before cleaning yielded MRSA, 70% by direct plating. After cleaning, all areas remained contaminated, with 66% of 124 swabs yielding MRSA, 74% by direct plating. In contrast, after exposing six rooms to hydrogen peroxide vapour, only one of 85 (1.2%) swabs yielded MRSA, by enrichment culture only. The hospital environment can become extensively contaminated with MRSA that is not eliminated by standard cleaning methods. In contrast, hydrogen peroxide vapour decontamination is a highly effective method of eradicating MRSA from rooms, furniture and equipment. Further work is needed to determine the importance of environmental contamination with MRSA and the effect on hospital infection rates of effective decontamination.
authors.affiliation: Department of Infection, King's College London, North Wing, St Thomas' Hospital, UK. gary.french@kcl.ac.uk
authors.forename: G L
authors.initials: GL
authors.lastname: French
authors.forename: J A
authors.initials: JA
authors.lastname: Otter
authors.forename: K P
authors.initials: KP
authors.lastname: Shannon
authors.forename: N M T
authors.initials: NM
authors.lastname: Adams
authors.forename: D
authors.initials: D
authors.lastname: Watling
authors.forename: M J
authors.initials: MJ
authors.lastname: Parks
mesh_terms: D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods*; D004866:Equipment Contamination / Q000517:prevention & control / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D006861:Hydrogen Peroxide; D008131:London; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D014835:Volatilization
chemical_list: D006861:Hydrogen Peroxide