A pilot study into locating the bad bugs in a busy intensive care unit

Area of Science:

• Infection Control and Prevention
• Environmental Microbiology
• Intensive Care Medicine

Background:

• Multidrug-resistant organisms (MDROs) pose a significant threat to patient safety in intensive care units (ICUs).
• MDROs can persist in dry surface biofilms, creating challenging reservoirs for eradication.
• Identifying MDRO locations is crucial for effective infection control interventions.

Purpose of the Study:

• To investigate a novel approach for identifying MDRO reservoirs within ICUs.
• To evaluate the utility of adenosine triphosphate (ATP) bioluminometers in environmental sampling for MDROs.
• To determine the common locations and types of surfaces harboring MDROs in the ICU environment.

Main Methods:

• Employed an aggressive environmental swabbing technique targeting high-touch objects (HTOs) and surfaces.
• Utilized two commercially available adenosine triphosphate (ATP) bioluminometers to assess surface cleanliness.
• Correlated ATP readings with the identification of MDRO locations through subsequent sampling.

Main Results:

• Successfully identified 13 distinct MDRO locations within the ICU environment.
• ATP bioluminometer use was significantly associated with the detection of 12 out of 13 MDRO locations.
• No significant correlation was found between MDRO recovery and ATP readings from the two devices or between the devices themselves.

Conclusions:

• MDRO locations were not confined to patient areas but were found across various HTOs and surfaces.
• ATP testing proved effective in rapidly identifying contaminated sites for targeted MDRO sampling.
• The clinical staff workstation emerged as a primary location with the highest density of positive MDRO findings.