title: Intrinsic bacterial burden associated with intensive care unit hospital beds: effects of disinfection on population recovery and mitigation of potential infection risk.
abstract: BACKGROUND
  Commonly touched items are likely reservoirs from which patients, health care workers, and visitors may encounter and transfer microbes. A quantitative assessment was conducted of the risk represented by the intrinsic bacterial burden associated with bed rails in a medical intensive care unit (MICU), and how disinfection might mitigate this risk.
  
  
  METHODS
  Bacteria present on the rails from 36 patient beds in the MICU were sampled immediately before cleaning and at 0.5, 2.5, 4.5, and 6.5 hours after cleaning. Beds were sanitized with either a bottled disinfectant (BD; CaviCide) or an automated bulk-diluted disinfectant (ABDD; Virex II 256).
  
  
  RESULTS
  The majority of bacteria recovered from the bed rails in the MICU were staphylococci, but not methicillin-resistant Staphylococcus aureus. Vancomycin-resistant enterococci were recovered from 3 beds. Bottled disinfectant reduced the average bacterial burden on the rails by 99%. However, the burden rebounded to 30% of that found before disinfection by 6.5 hours after disinfection. ABDD reduced the burden by an average of 45%, but levels rebounded within 2.5 hours. The effectiveness of both disinfectants was reflected in median reductions to burden of 98% for BD and 95% for ABDD.
  
  
  CONCLUSIONS
  Cleaning with hospital-approved disinfectants reduced the intrinsic bacterial burden on bed rail surfaces by up to 99%, although the population, principally staphylococci, rebounded quickly to predisinfection levels.
authors.affiliation: Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Hubert H
authors.initials: HH
authors.lastname: Attaway
authors.forename: Sarah
authors.initials: S
authors.lastname: Fairey
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Steed
authors.forename: Cassandra D
authors.initials: CD
authors.lastname: Salgado
authors.forename: Harold T
authors.initials: HT
authors.lastname: Michels
authors.forename: Michael G
authors.initials: MG
authors.lastname: Schmidt
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000517:prevention & control*; D058491:Bacterial Load; D001513:Beds / Q000382:microbiology*; D004203:Disinfection / Q000379:methods*; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units