Contaminated Hospital Floors Help Spread Infection

A new study suggests that ward floors may be an overlooked source of healthcare-associated infections (HAIs) by pathogens such as Clostridium difficile and methicillin-resistant staphylococcus aureus (MRSA).

Researchers at Case Western Reserve University and the Cleveland Veterans Affairs Medical Center conducted a survey in five hospitals in the Cleveland area, culturing and examining samples from 318 floor sites from 159 patient rooms (two sites per room), including C. difficile infection (CDI) isolation rooms and non-CDI rooms. They also took samples from the bare and gloved hands of healthcare staff, as well as from other high-touch surfaces including call buttons, medical devices, linen, medical supplies, and clothing.

The results revealed that the floors in patient rooms were often contaminated with MRSA, vancomycin-resistant enterococci, and C. difficile, which was the most frequently recovered pathogen in both CDI isolation rooms and non-CDI rooms, as well as from bare or gloved hands that handled items. In addition, of 100 occupied rooms surveyed, 41% had one or more high-touch objects in contact with the floor; these included personal items, medical devices, and supplies. The study was published in the March 2017 issue of the American Journal of Infection Control.

“Efforts to improve disinfection in the hospital environment usually focus on surfaces that are frequently touched by the hands of healthcare workers or patients; limited attention has been paid to disinfection of floors because they are not frequently touched,” said lead author Abhishek Deshpande, MD, PhD, of CWRU. “The results of our study suggest that floors in hospital rooms could be an underappreciated source for dissemination of pathogens and are an important area for additional research.”

“Understanding gaps in infection prevention is critically important for institutions seeking to improve the quality of care offered to patients,” added Linda Greene, RN, MPS, CIC, president of the Association for Professionals in Infection Control and Epidemiology (APIC; Arlington, VA, USA). “Even though most facilities believe they are taking the proper precautions, this study points out the importance of ensuring cleanliness of the hospital environment and the need for education of both staff and patients on this issue.”