Hospital floors are hotspot for bacteria, creating route of transfer to patients

NEW YORK (October 30, 2020) — The floors of hospital rooms are quickly and frequently contaminated with antibiotic-resistant bacteria within hours of patient admission, creating a route of transfer of potentially dangerous organisms to patients, according to a study published today as part of the proceedings from Decennial 2020: The Sixth International Conference on Healthcare-Associated Infections. Decennial 2020, an initiative of the Centers for Disease Control and Prevention and the Society for Healthcare Epidemiology of America, was cancelled in March due to the pandemic. All abstracts accepted for the meeting have been published as a supplement issue in the journal Infection Control & Hospital Epidemiology.

“If bacteria stayed on floors this wouldn’t matter, but we’re seeing clear evidence that these organisms are transferred to patients, despite our current control efforts,” said Curtis Donskey, MD, senior author of the study and hospital epidemiologist at the Cleveland VA Medical Center. “Hand hygiene is critical, but we need to develop practical approaches to reduce underappreciated sources of pathogens to protect patients.”

Researchers with the Northeast Ohio VA Healthcare System closely tracked contamination in hospital rooms of 17 newly admitted patients to identify the timing and route of transfer of bacteria within patients’ rooms. Before testing, rooms were thoroughly cleaned and sanitized and all patients screened negative for methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated bacteria. Researchers then observed patients’ interactions with healthcare personnel and portable equipment, collecting cultures one-to-three times per day from patients, their socks, beds and other high-touch surfaces, as well as key sections of the floor.

Nearly half of rooms tested positive for MRSA within the first 24 hours, and MRSA, C. difficile, and vancomycin-resistant enterococci (VRE) pathogens were identified in 58% of patient rooms within four days of admission. Contamination often started on the floors, but ultimately moved to patients’ socks, bedding, and nearby surfaces.

“While we’re showing that these scary sounding bugs can make their way into a patient’s room and near them, not everyone who encounters a pathogen will get an infection,” said Sarah Redmond, lead author and a medical student at Case Western Reserve University School of Medicine. “With that in mind, are there simple ways to address these areas of exposure without placing too much emphasis on the risk?”

In a related study published in August in Infection Control & Hospital Epidemiology, the authors reported similar findings of frequent detection of SARS-CoV-2 nucleic acid on floors and on shoes of personnel on a COVID-19 ward. The authors note that further research is needed to clarify the role of floor contamination in transmission of both bacterial and viral pathogens and to identify practical approaches to address contamination. On the COVID-19 ward, contamination was reduced with simple modifications of floor cleaning and disinfection protocols.

Researchers noted several limitations of the study, including the small sample size and variables in characteristics among patients and healthcare personnel that may impact how generalizable the study findings are to other hospitals.

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The Decennial is held once every 10 years and reviews the advances of the previous decade and the opportunities and trends for the fields of healthcare epidemiology, infectious diseases, infection prevention, and antibiotic stewardship for the future. Decennial 2020, planned for March 26-30, 2020, was to be co-hosted by the Society for Healthcare Epidemiology of America (SHEA) and the Centers for Disease Control and Prevention (CDC). For more information, visit http://www.decennial2020.org. #Decennial2020

The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 3,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society’s work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at http://www.shea-online.org, http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.

Centers for Disease Control and Prevention (CDC) is one of the major operating components of the Department of Health and Human Services. CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

Division of Healthcare Quality Promotion – Within CDC, it is the mission of the Division of Healthcare Quality Promotion (DHQP) to protect patients; protect healthcare personnel; and promote safety, quality, and value in both national and international healthcare delivery systems.