title: Isolation of Acinetobacter baumannii complex and methicillin-resistant Staphylococcus aureus from hospital rooms following terminal cleaning and disinfection: can we do better?
abstract: OBJECTIVE
  To study the frequency of isolation of Acinetobacter baumannii complex (ABC) and methicillin-resistant Staphylococcus aureus (MRSA) from surfaces of rooms newly vacated by patients with multidrug-resistant (MDR) ABC following various rounds of routine terminal cleaning and disinfection (C/D) with bleach or 1 round of C/D followed by hydrogen peroxide vapor (HPV) treatment.
  
  
  METHODS
  A 900-bed tertiary care hospital.
  
  
  METHODS
  ABC and MRSA cultures were obtained from hospital rooms including 312 rooms (mean, 18.3 sites/room) following 4 rounds of C/D, 37 rooms (mean, 20 sites/room) following 1 round of C/D before and after HPV treatment, and 134 rooms (mean, 20 sites/room) following 1 round of C/D and HPV treatment.
  
  
  RESULTS
  Following 4 rounds of C/D, 83 (26.6%) rooms had 1 or more culture-positive sites; 102 (1.8%) sites in 51 (16.4%) rooms grew ABC, and 108 (1.9%) sites in 44 (14.1%) rooms grew MRSA. The addition of HPV treatment to 1 round of C/D resulted in a significant drop in ABC- and MRSA-positive room sites (odds ratio, 0 [95% confidence interval, 0-0.8]; P = .04 for both organisms). Following 1 round of C/D and HPV treatment, 6 (4.5%) rooms were culture-positive for ABC, MRSA, or both.
  
  
  CONCLUSIONS
  Routine terminal C/D of hospital rooms vacated by MDRABC-positive patients may be associated with a significant number of ABC- or MRSA-positive room surfaces even when up to 4 rounds of C/D are performed. The addition of HPV treatment to 1 round of C/D appears effective in reducing the number of persistently contaminated room sites in this setting.
authors.affiliation: Division of Infectious Diseases, St John's Mercy Medical Center, St Louis, Missouri 63141, USA. farrinman@gmail.com
authors.forename: Farrin A
authors.initials: FA
authors.lastname: Manian
authors.forename: Sandra
authors.initials: S
authors.lastname: Griesenauer
authors.forename: Diane
authors.initials: D
authors.lastname: Senkel
authors.forename: Janice M
authors.initials: JM
authors.lastname: Setzer
authors.forename: Sara A
authors.initials: SA
authors.lastname: Doll
authors.forename: Annie M
authors.initials: AM
authors.lastname: Perry
authors.forename: Michelle
authors.initials: M
authors.lastname: Wiechens
mesh_terms: D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D004202:Disinfectants; D004203:Disinfection / Q000379:methods*; D024901:Drug Resistance, Multiple, Bacterial; D004866:Equipment Contamination; D006761:Hospitals; D006801:Humans; D006861:Hydrogen Peroxide; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D010362:Patients' Rooms; D012973:Sodium Hypochlorite
chemical_list: D004202:Disinfectants; D006861:Hydrogen Peroxide; D012973:Sodium Hypochlorite