Table 6.
Relation between the reduction in environmental bioburden and patient colonization or healthcare- associated infection following an environmental hygiene intervention; systematic review
| Authors | Interventions | Bioburden measurement: ATP/culture | Microorganisms with significant reduction for colonization | Microorganisms with significant reduction for HAI | Total microorganisms evaluated for colonization or HAI |
|---|---|---|---|---|---|
| Lowbury et al. [25] | Isolators for burn patients | Settle plates of S. aureus | NA | NA | Coliform bacilli, P. aeruginosa, Proteus sp., S. aureus |
| Wilcox et al. [44] | Hypochlorite, training | Culture of C. difficile | NA | C. difficile | C. difficile |
| Boyce et al. [31] | Gaseous hydrogen peroxide (HPV) | Culture of C. difficile | No | C. difficile | C. difficile |
| Salgado et al. [37] | Copper alloy-coating | Culture of MRSA, VRE, A. baumanni, P. aeruginosa, E. coli | Composite (MRSA, VRE) | Composite (MRSA, VRE) | MRSA, VRE |
| Mitchell et al. [46] | Gaseous HP (HPV) and liquid HP; monitoring, feedback | Culture of MRSA | MRSA | MRSA | MRSA |
| Anderson et al. [48] | UV-C terminal room disinfection ± Bleach | Culture of MRSA, VRE, C. difficile, MDR A. baumannii | VRE and composite (MDR A. baumannii, S. aureus, VRE) | VRE for bleach and bleach + UV arms | C. difficile, MDR A. baumannii, S. aureus, VRE |
| Boyce et al. [32] | Liquid HP, feedback | Culture of MRSA, VRE, C. difficile | No | No | C. difficile, MRSA, VRE |
| Green et al. [30] | Pulsed Xenon UV | Culture of (Bacillus spp., coagulase negative staphylococci, Micrococcus spp., Corynebacterium aurimucosum, Dietzia cinnamea, Moraxella osloensis, Sphingomonas paucimobilis, mold, other presumed environmental isolates (listed as large Gram-positive cocci, Gram-positive rods, or unknown/not described); gram negative rod, MDRO, C. difficile) | No | No | C. difficile, ESBL Enterobacteriacae, MDR P.aeruginosa, MRSA, S. maltophilia |
| Kovach et al. [24] | Pulsed Xenon UV | ATP; culture of gram-positive cocci or rod, gram-positive bacilli | No | NA | NA |
| Ray et al. [39] | Training, monitoring, feedback | ATP; culture of C. difficile | No | No | C. difficile |
| Kim et al. [34] | Photocatalyst antimicrobial coating (TiO2) | Culture of Staphylococcus spp., Bacillus spp. | MRSA | No | A. baumannii, C. difficile, MRSA, VRE |
| Wong et al. [42] | Training, education, color-coded wipes | ATP | NA | No | C. difficile, MRSA, VRE |
| Hung et al. [41] | Education, feedback, redesigned workflow | ATP; aerobic colony counts (ACC) of unknown micro-organisms | Composite (CRABC, MRSA, VRE) | No | CRABC, MRSA, VRE |
ATP adenosine triphosphate, CRBAC Carbapenem-resistant Acinetobacter baumannii complex, MRSA multidrug-resistant S. aureus, VRE vancomycin-resistant enterococci, N/A not available