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Microbial burden on environmental surfaces in long-term care facilities: a quantitative analysis
William A Rutala1,2, Lauren M DiBiase1,3, Amy W Powell1
1Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC, USA.
Background:
We conducted a quantitative analysis of the microbial burden and prevalence of epidemiologically important pathogens (EIP) found on long-term care facilities (LTCF) environmental surfaces.
Methods:
Microbiological samples were collected using Rodac plates (25cm2/plate) from resident rooms and common areas in five LTCFs. EIP were defined as MRSA, VRE, C. difficile and multidrug-resistant (MDR) Gram-negative rods (GNRs).
Results:
Rooms of residents with reported colonization had much greater EIP counts per Rodac (8.32 CFU, 95% CI 8.05, 8.60) than rooms of non-colonized residents (0.78 CFU, 95% CI 0.70, 0.86). Sixty-five percent of the resident rooms and 50% of the common areas were positive for at least one EIP. If a resident was labeled by the facility as colonized with an EIP, we only found that EIP in 30% of the rooms. MRSA was the most common EIP recovered, followed by C. difficile and MDR-GNR.
Discussion:
We found frequent environmental contamination with EIP in LTCFs. Colonization status of a resident was a strong predictor of higher levels of EIP being recovered from his/her room.
Insights
Environmental surfaces in long-term care facilities (LTCFs) frequently harbor epidemiologically important pathogens (EIP). Resident colonization is a strong predictor of higher EIP levels in their rooms.
Area of Science:
- Infection control
- Microbiology
- Environmental hygiene
Background:
- Long-term care facilities (LTCFs) present unique challenges for infection control due to vulnerable populations.
- Environmental surfaces can act as reservoirs for epidemiologically important pathogens (EIP).
Purpose of the Study:
- To quantitatively analyze the microbial burden and prevalence of EIP on environmental surfaces in LTCFs.
- To assess the relationship between resident colonization status and environmental contamination.
Main Methods:
- Microbiological samples were collected from resident rooms and common areas in five LTCFs using Rodac plates.
- Epidemiologically important pathogens (EIP) included methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), Clostridioides difficile, and multidrug-resistant Gram-negative rods (MDR-GNRs).
Main Results:
- Rooms of colonized residents showed significantly higher EIP counts (8.32 CFU) compared to non-colonized residents (0.78 CFU).
- Sixty-five percent of resident rooms and 50% of common areas were contaminated with at least one EIP.
- MRSA was the most frequently detected EIP, followed by C. difficile and MDR-GNRs.
Conclusions:
- Frequent environmental contamination with EIP is prevalent in LTCFs.
- Resident colonization status is a significant predictor of increased EIP levels in the immediate room environment.
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