title: Effect of surface coating and finish upon the cleanability of bed rails and the spread of Staphylococcus aureus.
abstract: BACKGROUND
  Bacterial reservoirs in the near-patient environment are likely vectors of healthcare-acquired infection.
  
  
  OBJECTIVE
  To conduct a laboratory-based study to confirm a previous clinical finding of higher numbers of bacteria on plastic than on painted steel bed rails.
  
  
  METHODS
  Six different surfaces were inoculated with Staphylococcus aureus suspended in a range of synthetic soils. Aerobic colony counts and ATP bioluminescence were used to assess the efficacy of cleaning with microfibre cloths and antibacterial wipes. The ease with which S. aureus was transferred between fingertips and each bed rail was also investigated.
  
  
  RESULTS
  Antibacterial wipes reduced bacterial numbers to below detectable levels on all rails but were less effective than microfibre cloths in removing organic debris. Surfaces that were comparatively easy to clean were more likely to transfer S. aureus on contact. If inadequately disinfected these rails could pose the greatest risk in terms of cross-transmission. In the absence of contaminating soil, bacterial transfer from fingertips to rail ranged from 38% to 64%. Transfer from rail to fingertip ranged from 22% to 38%. Surface material and rugosity were important factors in determining cleanability and transfer rate. However, the presence of organic soils affected bacterial transfer from all bed rails regardless of material or finish.
  
  
  CONCLUSIONS
  Bed rails can become heavily contaminated. Regular wiping with antibacterial wipes could be a cost-effective means of maintaining low numbers of bacteria near to the patient. To minimize the risk of cross-transmission, cleaning protocols should be validated to ensure effective removal of microbial and non-microbial surface contamination.
authors.affiliation: Department of Clinical Microbiology, University College London Hospital, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Ali
authors.forename: G
authors.initials: G
authors.lastname: Moore
authors.forename: A P R
authors.initials: AP
authors.lastname: Wilson
mesh_terms: D001513:Beds / Q000382:microbiology*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000382:microbiology / Q000635:transmission*; D003666:Decontamination / Q000379:methods; D004866:Equipment Contamination / Q000517:prevention & control; D006801:Humans; D011091:Polyesters; D011126:Polypropylenes; D013203:Staphylococcal Infections / Q000382:microbiology / Q000635:transmission*; D013211:Staphylococcus aureus / Q000254:growth & development* / Q000302:isolation & purification; D013232:Steel; D013499:Surface Properties
chemical_list: D011091:Polyesters; D011126:Polypropylenes; D013232:Steel