The impact of enhanced cleaning on bacterial contamination of the hospital environmental surfaces: a clinical trial in critical care unit in an Egyptian hospital

Nermine Mahmoud Hassan Hamed; Osama Ahmed Deif; Aleya Hanafy El-Zoka; Magda Mohamed Abdel-Atty; Mohamed Fakhry Hussein

doi:10.1186/s13756-024-01489-z

The impact of enhanced cleaning on bacterial contamination of the hospital environmental surfaces: a clinical trial in critical care unit in an Egyptian hospital

Antimicrob Resist Infect Control. 2024 Nov 19;13(1):138. doi: 10.1186/s13756-024-01489-z.

Authors

Nermine Mahmoud Hassan Hamed¹, Osama Ahmed Deif², Aleya Hanafy El-Zoka³, Magda Mohamed Abdel-Atty⁴, Mohamed Fakhry Hussein⁵

Affiliations

¹ Alexandria University Hospitals, Alexandria University, Alexandria, Egypt.
² Neurosurgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
³ Environmental Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
⁴ Environmental Chemistry and Biology, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
⁵ Environmental Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt. [email protected].

PMID: 39563364
DOI: 10.1186/s13756-024-01489-z

Abstract

Background: Contaminated environmental surfaces play an important role in the transmission of pathogens that cause healthcare acquired infection (HAI). The present study aimed to assess the effect of enhanced cleaning techniques on bacterial contamination in high-touch areas compared to routine cleaning at the intensive care units (ICU) of the neurosurgery department of Alexandria Main University Hospital, Egypt.

Methods: The assessment of the knowledge and practices of healthcare cleaning workers and nurses was conducted through a questionnaire and an observational checklist. An educational program about enhanced cleaning was carried out for healthcare cleaning workers and nurses in one room of the ICU unit. Environmental surface swabs were taken from the two rooms of the ICU before and after cleaning (room A and room B). Room A was selected to apply the enhanced cleaning, and room B was selected for routine cleaning.

Results: A significant decrease in bacterial counts in the high-touch areas around the patients after the application of enhanced cleaning compared to routine cleaning (p < 0.001) was observed. Gram-negative bacteria isolated from high-touch areas accounted for 45.6% of the samples collected before enhanced cleaning, and they became 16.3% after enhanced cleaning (p < 0.001), while they accounted for 40% after routine cleaning. The enhanced cleaning intervention in Room A resulted in a significant reduction in total infections, decreasing from 18 cases in the six months prior to the intervention to 11 cases in the six months following its implementation. (p < 0.05).

Conclusion: The effect of enhanced cleaning was evident in decreasing bacterial counts in the high-touch areas around the patient and consequently in the records of the HAI rate inside the ICU.

Clinical trial registration number: PACTR202402531001186, date: 15 February 2024, 'retrospectively registered'.

Keywords: Bacterial contamination; Enhanced cleaning; Healthcare acquired infection; Healthcare facilities; Infection prevention and control; Nosocomial infections.

Publication types

Clinical Trial

MeSH terms

Cross Infection* / prevention & control
Disinfection / methods
Egypt
Equipment Contamination
Gram-Negative Bacteria / isolation & purification
Hospitals, University
Housekeeping, Hospital / methods
Humans
Infection Control / methods
Intensive Care Units*
Surveys and Questionnaires