'High-touch' surfaces are not always 'high-risk' surfaces in the intensive care unit environment

Area of Science:

• Infection Control
• Hospital Epidemiology
• Microbiology

Background:

• Hospital-associated infections (HAIs) pose a significant threat in intensive care units (ICUs).
• Fomite transmission is a key route for HAIs, necessitating identification of high-risk items (HRIs).
• Current strategies often focus on high-touch items (HTIs), but their role in contamination requires further investigation.

Purpose of the Study:

• To identify HRIs involved in fomite transmission of HAIs within an ICU setting.
• To quantify bacterial contamination levels on identified HRIs.
• To compare contamination levels between HRIs, HTIs, and low-touch items.

Main Methods:

• Conducted 15-day hand-to-surface contact observations in a 13-bed ICU.
• Utilized directed weighted networks to identify HRIs based on centrality analysis.
• Collected aerobic bacteria samples from various surfaces at multiple time points over four days.

Main Results:

• High-risk items (HRIs) were identified, though not always overlapping with high-touch items (HTIs).
• Bacterial contamination levels on HRIs were significantly higher than on low-risk items.
• No significant difference in bacterial contamination was found between HTIs and low-touch items.

Conclusions:

• Network analysis effectively identifies HRIs for targeted cleaning and disinfection in ICUs.
• Relying solely on high-touch items may not be sufficient for effective infection control.
• Precise identification of HRIs enhances the efficacy of surface disinfection strategies to reduce HAIs.