Considering the risk of contamination of privacy curtains in hospitals

A Canadian study reports the findings of a prospective survey of bacterial contamination of privacy curtains in hospitals. The curtains became contaminated with antibiotic resistant bacteria within weeks of being introduced into the clinical environment. The calls into question the management of privacy curtains in the healthcare setting.

Previous studies have found that privacy curtains can be contaminated with antibiotic-resistant bacteria when sampled at a point in time. The unique aspect of this study was that 8 newly hung test curtains in a ward were sampled regularly over 21 days, and compared to control curtains hung in non-clinical areas. This allows us to understand how rapidly the curtains became contaminated. Within 3 days, the curtains in the clinical areas were showing increased contamination compared with the control curtains, and by day 14, 5 of the 8 curtains were contaminated with MRSA.

Protocols for managing privacy curtains vary considerably from hospital to hospital. Some are changed regularly, others, once in a blue moon! Whilst it may be possible to partially disinfect curtains whilst they are hung in a clinical setting (e.g. by using a chemical spray), this will be challenging. Therefore, linen privacy curtains should be changed frequently, and immediately if visibly contaminated with blood or other body fluid and after moving a patient known to be infected or colonised with antibiotic resistant bacteria or other HCAI pathogens such as C. difficile or norovirus. Also, it's worth considering other patient privacy options (such as non-linen curtains, disposable curtains, screens, or temporary single rooms).

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Extensive environmental contamination with carbapenem-resistant Acinetobacter baumannii

A study from Singapore has highlighted extensive environmental contamination with carbapenem-resistant Acinetobacter baumannii in the ICU. This reinforces the need for enhanced environmental measures to reduce the transmission of carbapenem-resistant Acinetobacter baumannii in the ICU setting.

Carbapenem-resistant Acinetobacter baumannii is in many ways a scary organism: it's highly resistant to antibiotics with few therapeutic options left in some cases, seems to spread readily in ICUs and burns units, and has an extraordinary ability to survive in the dry environment. One study reported that A. baumannii can survive for more than a year on dry surfaces - and that's without a water or nutrient source!

During an outbreak of carbapenem-resistant Acinetobacter baumannii in an ICU in Singapore, the team performed a point prevalence survey of patient colonisation / infection and environmental contamination with carbapenem-resistant Acinetobacter baumannii. Environmental contamination was identified in 28% (5/18) of the rooms on the ICU. Whole genome sequencing found that environmental isolates were closely related to the patient in the room, but differed between rooms. This suggests that the environmental isolates originated from the patient in the room.

These findings reinforce the need for enhanced disinfection when dealing with carbapenem-resistant Acinetobacter baumannii, especially at the time of patient discharge. This will reduce the risk that contaminated surfaces become a reservoir for room-to-room transmission of carbapenem-resistant Acinetobacter baumannii.

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