title: Use of a daily disinfectant cleaner instead of a daily cleaner reduced hospital-acquired infection rates.
abstract: BACKGROUND
  Documenting effective approaches to eliminate environmental reservoirs and reduce the spread of hospital-acquired infections (HAIs) has been difficult. This was a prospective study to determine if hospital-wide implementation of a disinfectant cleaner in a disposable wipe system to replace a cleaner alone could reduce HAIs over 1 year when housekeeping compliance was ≥80%.
  
  
  METHODS
  In this interrupted time series study, a ready-to-use accelerated hydrogen peroxide disinfectant cleaner in a disposable wipe container system (DCW) was used once per day for all high-touch surfaces in patient care rooms (including isolation rooms) to replace a cleaner only. The HAI rates for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile were stratified by housekeeping cleaning compliance (assessed using ultraviolet-visible marker monitoring).
  
  
  RESULTS
  When cleaning compliance was ≥80%, there was a significant reduction in cases/10,000 patient days for MRSA (P = .0071), VRE (P < .0001), and C difficile (P = .0005). For any cleaning compliance level there was still a significant reduction in the cases/10,000 patient days for VRE (P = .0358).
  
  
  CONCLUSIONS
  Our study data showed that daily use of the DCW applied to patient care high-touch environmental surfaces with a minimum of 80% cleaning compliance was superior to a cleaner alone because it resulted in significantly reduced rates of HAIs caused by C difficile, MRSA, and VRE.
authors.affiliation: St Boniface Research Centre, Winnipeg, MB, Canada; Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada. Electronic address: malfa@sbrc.ca.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Alfa
authors.affiliation: Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada; St Boniface Hospital, Winnipeg, MB, Canada.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Lo
authors.affiliation: St Boniface Research Centre, Winnipeg, MB, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Olson
authors.affiliation: St Boniface Hospital, Winnipeg, MB, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: MacRae
authors.affiliation: St Boniface Hospital, Winnipeg, MB, Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: Buelow-Smith
mesh_terms: D016360:Clostridioides difficile / Q000187:drug effects*; D003428:Cross Infection / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods; D004202:Disinfectants / Q000494:pharmacology*; D004783:Environmental Microbiology; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*
chemical_list: D004202:Disinfectants
keywords: Clostridium difficile; Environmental cleaning; Housekeeping; Methicillin-resistant Staphylococcus aureus; Vancomycin-resistant enterococci