REVIEW
Mopping up hospital infection

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Abstract

: Hospital cleaning is a neglected component of infection control. In the UK, financial constraints have forced managers to re-evaluate domestic services and general cleaning has been reduced to the bare minimum. Services have been contracted out in some hospitals, which has further lowered standards of hygiene. Control of infection personnel believe that cleaning is important in preventing hospital-acquired infections but they do not manage domestic budgets and have failed to stop their erosion. It is difficult to defend high levels of hygiene when there is little scientific evidence to support cleaning practices. This review examines the common micro-organisms associated with hospital-acquired infection and their ability to survive in the hospital environment. It also describes studies which suggest that comprehensive cleaning disrupts the chain of infection between these organisms and patients. It is likely that restoring hygienic standards in hospitals would be a cost-effective method of controlling hospital-acquired infection. Furthermore, good cleaning is achievable whereas the enforcement of hand washing and good antibiotic prescribing are not.

References (140)

  • S. Heard et al.

    A pseudo-outbreak of Pseudomonas on a special care baby unit

    Journal of Hospital Infection

    (1990)
  • I. Phillips et al.

    Pseudomonas aeruginosa cross-infection due to contamination of respiratory apparatus

    Lancet

    (1965)
  • P.J. Sanderson et al.

    Recovery of coliforms from the hands of nurses and patients: activities leading to contamination

    Journal of Hospital Infection

    (1992)
  • E.K. Musa et al.

    The survival of Acinetobacter calcoaceticus inoculated on fingertips and on formica

    Journal of Hospital Infection

    (1990)
  • A. Jawad et al.

    Exceptional dessication tolerance of Acinetobacter radioresistens.

    Journal of Hospital Infection

    (1998)
  • E.O. Caul

    Small round structured viruses: airborne transmission and hospital control

    Lancet

    (1994)
  • J.C. Doultree et al.

    Inactivation of feline calicivirus, a Norwalk virus surrogate

    Journal of Hospital Infection

    (1999)
  • R.A. Cox et al.

    A major outbreak of methicillin-resistance Staphylococcus aureus caused by a new phage type (EMRSA-16)

    Journal of Hospital Infection

    (1995)
  • R.A. Cox et al.

    A major outbreak of methicillin-resistance Staphylococcus aureus caused by a new phage type (EMRSA-16)

    Journal of Hospital Infection

    (1995)
  • A. Stacey et al.

    Contamination of television sets by methicillin-resistant Staphylococcus aureus (MRSA)

    Letter, Journal of Hospital Infection

    (1998)
  • A. Stacey et al.

    Contamination of television sets by methicillin-resistant Staphylococcus aureus (MRSA)

    Letter, Journal of Hospital Infection

    (1998)
  • G.L. French et al.

    Walsh M

    Contamination of doctors and nurses pens with nosocomial pathogens. Lancet

    (1998)
  • R. Speers et al.

    Contamination of nurses uniforms with Staphylococcus aureus.

    Lancet

    (1969)
  • J.H.T. Wagenvoort et al.

    Long-term in-vitro survival of an epidemic MRSA phage-group III-29 strain

    Letter, Journal of Hospital Infection

    (1997)
  • T.M. Bauer et al.

    An epidemiological study assessing the relative importance of airborne and direct contact transmission of micro-organisms in a medical intensive care unit

    Journal of Hospital Infection

    (1990)
  • D.N.P. Kumari et al.

    Ventilation grilles as a potential source of methicillin-resistant Staphylococcus aureus causing an outbreak in an orthopaedic ward at a district general hospital

    Journal of Hospital Infection

    (1998)
  • S. Cotterill et al.

    An unusual source for an outbreak of methicillin-resistant Staphylococcus aureus on an intensive therapy unit

    Journal of Hospital Infection

    (1996)
  • K.D. Allen et al.

    Staff carriage of methicillin-resistant Staphylococcus aureus (EMRSA 15) and the home environment: a case report

    Journal of Hospital Infection

    (1997)
  • R.G. Masterton et al.

    Refractory methicillin-resistant Staphylococcus aureus carriage associated with contamination of the home environment

    Journal of Hospital Infection

    (1995)
  • A.M. Kearns et al.

    Nosocomial enterococci: resistance to heat and sodium hypochlorite

    Journal of Hospital Infection

    (1995)
  • J.W. Gray et al.

    Antibiotic-resistant enterococci

    Journal of Hospital Infection

    (1992)
  • M.A. Noble et al.

    The toilet as a transmission vector of vancomycin-resistant enterococci

    Journal of Hospital Infection

    (1998)
  • W.C. Noble et al.

    Co-transfer of vancomycin and other resistance genes from Enterococcus faecalis NCTC 12201 toStaphylococcus aureus.

    FEMS Microbiology letters

    (1992)
  • P. Hempshall et al.

    Dirt Alert

    Nursing Times

    (1998)
  • I.M. Maurer

    Hospital Hygiene, 3rd edition

    (1985)
  • H. Gaze

    Sweeping Change

    Nursing Times

    (1990)
  • P. Hempshall et al.

    Grime Watch

    Nursing Times

    (1998)
  • M. Rennie

    Germ Warfare

    Editorial, British Journal of Intensive Care

    (1998)
  • J.I. Hawker

    A survey of the implementation of health service guidelines on arrangements for infection control in health trusts in the West Midlands

    Communicable Disease and Public Health

    (1999)
  • M.A. Worsley

    Guidance for hospital personnel

  • G.A.J. Ayliffe et al.

    Ward floors and other surfaces as reservoirs of hospital infection

    Journal of Hygiene

    (1967)
  • Hospitals

    (1974)
  • D.G. Maki et al.

    Relation of the inanimate environment to endemic nosocomial infections

    New England Journal of Medicine

    (1982)
  • Watkins, D. Cleanliness in the Crimea Hospital Equipment & Supplies March 1997:...
  • Nightingale, F. (1859) Notes on Nursing, Revised Edition 1952. Gerald Duckworth and Co,...
  • M.J. Struelens et al.

    Control of nosocomial transmission of Clostridium difficile based on sporadic case surveillance

    American Journal of Medicine

    (1991)
  • W.A. Rutala et al.

    Inactivation of Clostridium difficile spores by disinfectants

    Infection Control and Hospital Epidemiology

    (1993)
  • L.V. McFarland et al.

    Nosocomial acquisition of Clostridium difficile infection

    New England Journal of Medicine

    (1989)
  • A.M. Savage et al.

    Nosocomial spread of Clostridium difficile.

    Infection Control

    (1983)
  • F.A. Manian et al.

    Clostridium difficile contamination of blood pressure cuffs: a call for a closer look at gloving practices in the era of universal precautions

    Infection Control and Hospital Epidemiology

    (1996)
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