Investigation of single-use versus reusable infectious waste containers as potential sources of microbial
Alice N Neely1, Matthew P Maley, Gary L Taylor
1Shriners Burns Hospital, Cincinnati, OH 45229, USA.
Background:
Laws require that infectious waste be segregated from noninfectious waste. Companies certified to dispose of infectious waste offer both reusable and single-use containers. The focus of this study was to determine if there would be a microbiologic advantage to the use of one type of container over another in a burn hospital.
Methods:
Monthly swab cultures were taken from the tops of >250 infectious waste containers during 2 years. Bacteria and fungi were identified. In a substudy swab cultures were taken from an area of reusable tops before and after cleaning to evaluate the efficacy of cleaning on both the number and type of microbes present. Infection rates for acute patients were compared before and after control measures were instituted to decrease microbial transfer from infectious waste containers to patients.
Results:
Cultures taken from reusable boxes when received from the container company showed that >99% were contaminated with bacteria or fungi; most were normal environmental or skin flora, but some cultures showed microorganisms that can be potentially harmful to patients with compromised immunity. Wiping the lids with a phenolic disinfectant decreased both the total microbial load (P <.001) and the variety of microbes present (P <.001). In contrast, only 10% of the incoming single-use boxes showed any contamination. Infection rates dropped from 5.8 to 3.2 per 100 burn patients (P <.05) after the institution of cleaning and other changes made to decrease the possibility of microbial transfer from the infectious waste boxes to the patients.
Conclusions:
Upon delivery, significantly fewer single-use infectious waste boxes were contaminated than reusable ones (P <.001). Extra infection control measures were needed when reusable infectious waste boxes were used in areas housing patients with compromised immunity. Facilities need be aware of the possible contamination of reusable infectious waste containers with microorganisms capable of causing nosocomial infections in patients who are compromised.
Insights
Single-use infectious waste containers show a microbiologic advantage over reusable ones in burn hospitals. This reduces contamination and patient infection rates, especially for immunocompromised individuals.
Area of Science:
- Infection Control
- Microbiology
- Hospital Waste Management
Background:
- Infectious waste requires segregation from noninfectious waste by law.
- Both reusable and single-use containers are available for infectious waste disposal.
- The study aimed to assess the microbiologic differences between container types in a burn hospital setting.
Purpose of the Study:
- To compare the microbial contamination levels of reusable versus single-use infectious waste containers.
- To evaluate the effectiveness of cleaning protocols for reusable containers.
- To determine the impact of container type on patient infection rates in a burn unit.
Main Methods:
- Monthly swab cultures of infectious waste container tops were performed over two years.
- Bacteria and fungi were identified from cultures.
- A substudy assessed reusable container top cleanliness before and after disinfection.
Main Results:
- Over 99% of incoming reusable containers were contaminated with bacteria or fungi, including potentially harmful microbes.
- Single-use containers showed contamination in only 10% of cases.
- Disinfection significantly reduced microbial load and variety on reusable container lids.
- Patient infection rates decreased significantly after implementing enhanced infection control measures.
Conclusions:
- Single-use infectious waste containers are significantly less contaminated upon delivery compared to reusable ones.
- Reusable containers necessitate stringent infection control measures, particularly in proximity to immunocompromised patients.
- Healthcare facilities must be aware of the potential for nosocomial infections from contaminated reusable infectious waste containers.
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