Authors (including presenting author) :
Lai WMY(1), Wong WM(1), Wong YCA(1), Chow SH(1), Ng SW(1), Yip PN(1), Wong YM(1), Tsen OW(1), Chen MN(1), Ng SL(1), Chau KY(1), Tsang HY(1), Kong HY(1), Chen WY(1)
Affiliation :
(1) Infection Control Team, Pamela Youde Nethersole Eastern Hospital
Introduction :
In view of increasing incidents of multi-drugs resistant organisms (MDROs) found in clinical settings, apart from improving hand hygiene compliance among healthcare workers, patients and visitors, monitoring on environmental cleanliness is equally important to prevent MDRO contamination. Although UV florescence assessment is convenience. Comments received from frontline colleagues, results could be subjective.
Objectives :
To assess the degree of MDRO contamination in clinical areas
To assess the effectiveness of cleaning and disinfection in clinical areas
To provide quantified data for improvement as appropriate
Methodology :
Proceed environmental culture sampling (sampling) with a standard set of 16 sampling sites whenever a newly confirmed MDRO detected through a clinical specimen or clustering of MDRO detected in a clinical area in 2019. The 16 sampling sites were areas that frequently touched by staff and patients in clinical area.
Initial real-time sampling would be conducted before thorough environmental disinfection with 1,000 ppm Sodium Hypochlorite Solution and change curtains according to prevailing guideline. Repeated sampling(s) would be performed whenever positive site(s) was detected until results achieved all negative. Provide immediate feedback to clinical area in-charge on each sampling results.
Stratified the sampling results into 2 groups according to the sampling time, i.e. 6 months before and after the implementation of the sampling, to evaluate the effectiveness of the environmental monitoring.
Univariate analysis for the categorical value was performed using Pearson Chi-Square Test or Continuity Correction depended on the minimum expected count.
Result & Outcome :
Environmental sampling conducted in 19 clinical areas and the initial real-time sampling positive detection rate was 57.9% (11/19). A total of 438 samples were collected with overall positive rate at 14.4% (63/438). Top 3 sites with frequent MDRO contamination were curtain (32.4%), napkin trolley (23.8%) and trolley for urinary measurement (23.8%). Among the 63 positive sites, 95.2% (60/63) could turned negative in 2nd sampling after repeated environmental decontamination performed. 3 out of the 63 achieved all negative in the 3rd sampling. The number of positive sample detected were statistically significant lower after 6-month implementation of the sampling (Odds Ratio [OR]: 0.522; 95% Confidence Interval [CI]: 0.285, 0.955; P = 0.033).
