Assessment of materials commonly utilized in health care: Implications for bacterial survival and transmission

Background: Contaminated environmental surfaces, equipment, and health care workers' hands have been linked to outbreaks of infection or colonization because of vancomycin-resistant enterococci (VRE) and Pseudomonas aeruginosa (PSAE). Upholstery, walls, and flooring may enhance bacterial survival, providing infectious reservoirs. Objectives: investigate recovery of VRE and PSAE, determine efficacy of disinfection, and evaluate VRE transmission from surfaces. Methods: Upholstery, flooring, and wall coverings were inoculated with VRE and PSAE and assessed for recovery at 24 hours, 72 hours, and 7 days. inoculated surfaces were cleaned utilizing manufacturers' recommendations of natural, commercial, or hospital-approved products and methods, and samples were obtained. To assess potential for transmission, volunteers touched VRE-inoculated surfaces and imprinted palms onto contact-impression plates. Results: Twenty-four hours following inoculation, all surfaces had recovery of VRE 13 (92.9%) of 14 surfaces had persistent PSAE. After cleaning, VRE was recovered from 7 (50%) surfaces, PSAE from 5 (35.7%) surfaces. After inoculation followed by palmar contact, VRE was recovered from all surfaces touched. Conclusion: Bacteria commonly encountered in hospitals are capable of prolonged survival and may promote cross transmission. Selection of surfaces for health care environments should include product application and complexity of manufacturers' recommendations for disinfection. Recovery of organisms on surfaces and hands emphasizes importance of hand hygiene compliance prior to patient contact.