Table 5.
Effects of healthcare environmental hygiene interventions on healthcare-associated infections and patient colonization
| Author | Micro-organism | Intervention | Total reduction | Significant reduction | Effect of the HEH intervention |
|---|---|---|---|---|---|
| Wilcox et al. [44] | C. difficile | Hypochlorite | Yes | Yes |
Rate of colonization: NA Rate of HAI for both wards combined: 12.4–10 Unit of measure: 100 admissions RR: NA CI: NA P value: < 0.05 |
| Anderson et al. [48] | C. difficile | UV | Yes | No | Rate of colonization and rate of HAI (combined): 31.6–30.4 Unit of measure: 10,000 exposure days RR: 1.0 CI: 95%CI 0.57–1.75 P value: 0.997 |
| Boyce et al. [32] | C. difficile | Liquid hydrogen peroxide | Yes | No | Rate of colonization and rate of HAI (combined): 1.0–0.56 Unit of measure: number of cases per 1000 patient days RR: NA CI: NA P value: NA Composite outcome (colonization + HAI rate of all microbes): 10.3–8.0 incidence rate ratio 0.77; P = 0.068; 95%CI 0.579–1.029 |
| Ray et al. [39] | C. difficile | Training, monitoring and feedback | No | No | No data available for the intervention period. rate of colonization: NA rate of HAI for preintervention period only (intervention vs. control hospitals): 5.6–5.8 Unit of measure: 10,000 patient days RR: NA CI: NA P value: 0.8 |
| Mitchell et al. [47] | C. difficile | Bundle | No | No |
Rate of colonization: NA Rate of HAI: 2.34–2.52 Unit of measure: 10,000 occupied bed-days RR: 1.07 CI: 95%CI 0·88–1.30 P value: 0.4655 |
| Anderson et al. [48] | S. aureus | UV | Yes | No | Rate of colonization and rate of HAI (combined): 50.3–36.5 Unit of measure: 10,000 exposure days RR: 0.78 CI: 95%CI 0.58–1.05 P value: 0.104 |
| Anderson et al. [48] | S. aureus | Bleach | Yes | No | Rate of colonization and rate of HAI (combined): 50.3–48.2 Unit of measure: 10,000 exposure days RR: 1.00 CI: 95%CI 0.82–1.21 P value: 0.967 |
| Anderson et al. [48] | S. aureus | Bundle: UV + bleach | Yes | No | Rate of colonization and rate of HAI (combined): 50.3–46.9 Unit of measure: 10,000 exposure days RR: 0.97 CI: 95%CI 0.78–1.22 P value: 0.819 |
| Boyce et al. [32] | S. aureus (MRSA) | Liquid hydrogen peroxide | Yes | No | Rate of colonization and rate of HAI (combined): 2.79–1.96 Unit of measure: number of cases per 1,000 patient days RR: NA CI: NA P value: NA Composite outcome (colonization + HAI rate of all microbes): 10.3–8.0 incidence rate ratio 0.77; P = 0.068; 95%CI 0.579–1.029 |
| Mitchell et al. [47] | S. aureus | Bundle | Yes | No | Rate of colonization: NA rate of HAI: 0.97–0.80 Unit of measure: 10,000 occupied bed-days RR: 0.82 CI: 95%CI 0.60–1.12 P value:0.2180 |
| Anderson et al. [48] | VRE | UV | Yes | No | Rate of colonization and rate of HAI (combined): 63.4–29.4 Unit of measure: 10,000 exposure days RR: 0.41 CI: 95%CI 015–1.13 P value: 0.084 |
| Anderson et al. [48] | VRE | Bleach | Yes | Yes | Rate of colonization and rate of HAI (combined): 63.4–31.9 Unit of measure: 10,000 exposure days RR: 0.43 CI: 95%CI 0.19–1.00 P value: 0.049 |
| Anderson et al. [48] | VRE | Bundle: UV + bleach | Yes | Yes | Rate of colonization and rate of HAI (combined): 63.4–39.0 Unit of measure: 10,000 exposure days RR: 0.36 CI: 95%CI 0.18–0.70 P value: 0.003 |
| Boyce et al. [32] | VRE | Liquid hydrogen peroxide | Yes | No | Rate of colonization and rate of HAI (combined): 6.6–5.49 Unit of measure: number of cases per 1,000 patient days RR: NA CI: NA P value: NA Composite outcome (colonization + HAI rate of all microbes): 10.3–8.0 incidence rate ratio 0.77; P = 0.068; 95%CI 0.579–1.029 |
| Mitchell et al. [47] | VRE | Bundle | Yes | Yes | Rate of colonization: NA rate of HAI: 0.35–0.22 Unit of measure: 10,000 occupied bed-days RR: 0.63 CI: 95%CI 0.41–0.97 P value: 0.0340 |
Studies were selected if they had a quality rating of “A” or “B” (Table 4), used a control and if they studied the three most commonly-examined microorganisms
Significance of individual experiments on commonly studied microorganisms per method of intervention; systematic review