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Floors in hospital patients’ rooms are frequently contaminated with pathogens such as Clostridium difficile, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococci, which are easily transmitted to the hands of patients, care providers, and visitors, according to a report published in the American Journal of Infection Control.
Disinfection usually focuses on surfaces that are frequently touched by patients’ or health care workers’ hands, such as bed rails and call buttons. Floor disinfection has received limited attention.
However, floors are frequently touched by objects that are then handled, such as shoes and socks, said Abhishek Deshpande, MD, PhD, of the Cleveland Clinic, and his associates.
To examine the extent of floor contamination and the potential for transfer of pathogens to hands, the investigators surveyed five Cleveland-area hospitals. 
They collected samples from 1-square-foot areas of floors adjacent to beds and in bathrooms in C. difficile isolation rooms, and in 2-3 randomly selected nonisolation rooms on the same wards. At least 30 rooms at each hospital were cultured for C. difficile, MRSA, and VRE, either during a patient stay or after the rooms had been cleaned at patient discharge.
In addition, the researchers performed a point-prevalence survey of the number and type of high-touch objects contacting floors in 10-25 randomly selected occupied patient rooms at each hospital. After they handled these objects, their hands also were cultured.
Floor contamination was common with all of the pathogens, particularly with C. difficile. The frequency of contamination was similar across the five hospitals, in both bedroom and bathroom sites, and even in the 50 rooms that had been cleaned at the last patient discharge.
C. difficile spores were recovered from the floors of 47%-55% of rooms, MRSA was recovered from the floors of 8%-32% of rooms, and VRE were recovered from the floors of 13%-30% of rooms.
In addition, 41 of 100 occupied rooms had 1-4 “high-touch” objects in direct contact with the floors, including personal items such as clothing, canes, or cellphone chargers; medical supplies or devices such as pulse oximeters, call buttons, heating pads, urinals, blood pressure cuffs, and wash basins; and linens such as bed sheets, pillows, and towels.
Of the 31 cultures taken from both bare and gloved hands that handled these items, MRSA was recovered from 18%, VRE were recovered from 6%, and C. difficile was recovered from 3%.
“These results suggest that floors in hospital rooms could be an underappreciated source for dissemination of pathogens,” Dr. Deshpande and his associates noted (Am J Infect Control. 2017 Mar 1;45[3]:336-8).
“It would be reasonable to educate health care personnel and patients that they should avoid placing high-touch objects on the floor when possible,” they added.
Moreover, the efficacy of current floor-cleaning and disinfection techniques should be reexamined, particularly with regard to eliminating C. difficile spores.
Other modes of transmission from floors also should be assessed, such as contamination of wheelchairs and wheeled equipment. And transmission of other pathogens, such as gram-negative organisms and viruses, should be examined, the investigators said.
The Agency for Healthcare Research and Quality and the U.S. Department of Veterans Affairs funded the study. Dr. Deshpande reported receiving research grants from 3M, Clorox, and Steris, and one of his associates reported receiving research grants from Clorox, Ecolab, GOJO, Merck, Pfizer, and Steris.
Floors in hospital patients’ rooms are frequently contaminated with pathogens such as Clostridium difficile, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococci, which are easily transmitted to the hands of patients, care providers, and visitors, according to a report published in the American Journal of Infection Control.
Disinfection usually focuses on surfaces that are frequently touched by patients’ or health care workers’ hands, such as bed rails and call buttons. Floor disinfection has received limited attention.
However, floors are frequently touched by objects that are then handled, such as shoes and socks, said Abhishek Deshpande, MD, PhD, of the Cleveland Clinic, and his associates.
To examine the extent of floor contamination and the potential for transfer of pathogens to hands, the investigators surveyed five Cleveland-area hospitals.
They collected samples from 1-square-foot areas of floors adjacent to beds and in bathrooms in C. difficile isolation rooms, and in 2-3 randomly selected nonisolation rooms on the same wards. At least 30 rooms at each hospital were cultured for C. difficile, MRSA, and VRE, either during a patient stay or after the rooms had been cleaned at patient discharge.
In addition, the researchers performed a point-prevalence survey of the number and type of high-touch objects contacting floors in 10-25 randomly selected occupied patient rooms at each hospital. After they handled these objects, their hands also were cultured.
Floor contamination was common with all of the pathogens, particularly with C. difficile. The frequency of contamination was similar across the five hospitals, in both bedroom and bathroom sites, and even in the 50 rooms that had been cleaned at the last patient discharge.
C. difficile spores were recovered from the floors of 47%-55% of rooms, MRSA was recovered from the floors of 8%-32% of rooms, and VRE were recovered from the floors of 13%-30% of rooms.
In addition, 41 of 100 occupied rooms had 1-4 “high-touch” objects in direct contact with the floors, including personal items such as clothing, canes, or cellphone chargers; medical supplies or devices such as pulse oximeters, call buttons, heating pads, urinals, blood pressure cuffs, and wash basins; and linens such as bed sheets, pillows, and towels.
Of the 31 cultures taken from both bare and gloved hands that handled these items, MRSA was recovered from 18%, VRE were recovered from 6%, and C. difficile was recovered from 3%.
“These results suggest that floors in hospital rooms could be an underappreciated source for dissemination of pathogens,” Dr. Deshpande and his associates noted (Am J Infect Control. 2017 Mar 1;45[3]:336-8).
“It would be reasonable to educate health care personnel and patients that they should avoid placing high-touch objects on the floor when possible,” they added.
Moreover, the efficacy of current floor-cleaning and disinfection techniques should be reexamined, particularly with regard to eliminating C. difficile spores.
Other modes of transmission from floors also should be assessed, such as contamination of wheelchairs and wheeled equipment. And transmission of other pathogens, such as gram-negative organisms and viruses, should be examined, the investigators said.
The Agency for Healthcare Research and Quality and the U.S. Department of Veterans Affairs funded the study. Dr. Deshpande reported receiving research grants from 3M, Clorox, and Steris, and one of his associates reported receiving research grants from Clorox, Ecolab, GOJO, Merck, Pfizer, and Steris.
Floors in hospital patients’ rooms are frequently contaminated with pathogens such as Clostridium difficile, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococci, which are easily transmitted to the hands of patients, care providers, and visitors, according to a report published in the American Journal of Infection Control.
Disinfection usually focuses on surfaces that are frequently touched by patients’ or health care workers’ hands, such as bed rails and call buttons. Floor disinfection has received limited attention.
However, floors are frequently touched by objects that are then handled, such as shoes and socks, said Abhishek Deshpande, MD, PhD, of the Cleveland Clinic, and his associates.
To examine the extent of floor contamination and the potential for transfer of pathogens to hands, the investigators surveyed five Cleveland-area hospitals.
They collected samples from 1-square-foot areas of floors adjacent to beds and in bathrooms in C. difficile isolation rooms, and in 2-3 randomly selected nonisolation rooms on the same wards. At least 30 rooms at each hospital were cultured for C. difficile, MRSA, and VRE, either during a patient stay or after the rooms had been cleaned at patient discharge.
In addition, the researchers performed a point-prevalence survey of the number and type of high-touch objects contacting floors in 10-25 randomly selected occupied patient rooms at each hospital. After they handled these objects, their hands also were cultured.
Floor contamination was common with all of the pathogens, particularly with C. difficile. The frequency of contamination was similar across the five hospitals, in both bedroom and bathroom sites, and even in the 50 rooms that had been cleaned at the last patient discharge.
C. difficile spores were recovered from the floors of 47%-55% of rooms, MRSA was recovered from the floors of 8%-32% of rooms, and VRE were recovered from the floors of 13%-30% of rooms.
In addition, 41 of 100 occupied rooms had 1-4 “high-touch” objects in direct contact with the floors, including personal items such as clothing, canes, or cellphone chargers; medical supplies or devices such as pulse oximeters, call buttons, heating pads, urinals, blood pressure cuffs, and wash basins; and linens such as bed sheets, pillows, and towels.
Of the 31 cultures taken from both bare and gloved hands that handled these items, MRSA was recovered from 18%, VRE were recovered from 6%, and C. difficile was recovered from 3%.
“These results suggest that floors in hospital rooms could be an underappreciated source for dissemination of pathogens,” Dr. Deshpande and his associates noted (Am J Infect Control. 2017 Mar 1;45[3]:336-8).
“It would be reasonable to educate health care personnel and patients that they should avoid placing high-touch objects on the floor when possible,” they added.
Moreover, the efficacy of current floor-cleaning and disinfection techniques should be reexamined, particularly with regard to eliminating C. difficile spores.
Other modes of transmission from floors also should be assessed, such as contamination of wheelchairs and wheeled equipment. And transmission of other pathogens, such as gram-negative organisms and viruses, should be examined, the investigators said.
The Agency for Healthcare Research and Quality and the U.S. Department of Veterans Affairs funded the study. Dr. Deshpande reported receiving research grants from 3M, Clorox, and Steris, and one of his associates reported receiving research grants from Clorox, Ecolab, GOJO, Merck, Pfizer, and Steris.
FROM THE AMERICAN JOURNAL OF INFECTION CONTROL
Key clinical point: Floors in hospital patients’ rooms are frequently contaminated with pathogens that are easily transmitted to the hands of patients, care providers, and visitors.
Major finding: C. difficile spores were recovered from the floors of 47%-55% of rooms, MRSA was recovered from the floors of 8%-32% of rooms, and VRE were recovered from the floors of 13%-30% of rooms.
Data source: A survey of five Cleveland-area hospitals in which 318 samples were collected from floors in patient rooms and bathrooms.
Disclosures: The Agency for Healthcare Research and Quality and the U.S. Department of Veterans Affairs funded the study. Dr. Deshpande reported receiving research grants from 3M, Clorox, and Steris, and one of his associates reported receiving research grants from Clorox, Ecolab, Gojo, Merck, Pfizer, and Steris.