title: Decreasing operating room environmental pathogen contamination through improved cleaning practice.
abstract: OBJECTIVE
  Potential transmission of organisms from the environment to patients is a concern, especially in enclosed settings, such as operating rooms, in which there are multiple and frequent contacts between patients, provider's hands, and environmental surfaces. Therefore, adequate disinfection of operating rooms is essential. We aimed to determine the change in both the thoroughness of environmental cleaning and the proportion of environmental surfaces within operating rooms from which pathogenic organisms were recovered.
  
  
  METHODS
  Prospective environmental study using feedback with UV markers and environmental cultures.
  
  
  METHODS
  A 1,500-bed county teaching hospital.
  
  
  METHODS
  Environmental service personnel, hospital administration, and medical and nursing leadership.
  
  
  RESULTS
  The proportion of UV markers removed (cleaned) increased from 0.47 (284 of 600 markers; 95% confidence interval [CI], 0.42-0.53) at baseline to 0.82 (634 of 777 markers; 95% CI, 0.77-0.85) during the last month of observations ([Formula: see text]). Nevertheless, the percentage of samples from which pathogenic organisms (gram-negative bacilli, Staphylococcus aureus, and Enterococcus species) were recovered did not change throughout our study. Pathogens were identified on 16.6% of surfaces at baseline and 12.5% of surfaces during the follow-up period ([Formula: see text]). However, the percentage of surfaces from which gram-negative bacilli were recovered decreased from 10.7% at baseline to 2.3% during the follow-up period ([Formula: see text]).
  
  
  CONCLUSIONS
  Feedback using Gram staining of environmental cultures and UV markers was successful at improving the degree of cleaning in our operating rooms.
authors.affiliation: Department of Medicine, University of Miami, Miami, Florida, USA. smunozprice@med.miami.edu
authors.forename: L Silvia
authors.initials: LS
authors.lastname: Munoz-Price
authors.forename: David J
authors.initials: DJ
authors.lastname: Birnbach
authors.forename: David A
authors.initials: DA
authors.lastname: Lubarsky
authors.forename: Kristopher L
authors.initials: KL
authors.lastname: Arheart
authors.forename: Yovanit
authors.initials: Y
authors.lastname: Fajardo-Aquino
authors.forename: Mara
authors.initials: M
authors.lastname: Rosalsky
authors.forename: Timothy
authors.initials: T
authors.lastname: Cleary
authors.forename: Dennise
authors.initials: D
authors.lastname: Depascale
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coro
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
authors.forename: Philip
authors.initials: P
authors.lastname: Carling
mesh_terms: D004203:Disinfection / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D016983:Enterococcus / Q000302:isolation & purification*; D004866:Equipment Contamination / Q000517:prevention & control* / Q000706:statistics & numerical data; D005246:Feedback; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D016015:Logistic Models; D009873:Operating Rooms; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement / Q000706:statistics & numerical data; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D014466:Ultraviolet Rays