Study highlights role of hospital floors in spread of healthcare pathogens
Hospital room floors could be an underappreciated source of healthcare-associated pathogen spread, including those resistant to antibiotics, according to a study today in Infection Control and Hospital Epidemiology.
In the abstract from the March 2020 Decennial International Conference on Healthcare-Associated Infection, researchers from the Northeast Ohio Veterans Administration (VA) Healthcare System and Cleveland VA Medical Center observed the interactions of patients, hospital workers, and portable equipment in thoroughly cleaned hospital rooms of 17 newly admitted patients who had tested negative for carriage of methicillin-resistant Staphylococcus aureus (MRSA). They then collected cultures from patient skin and room surfaces, including the floors, one to three times a day, focusing on surfaces in contact with personnel and portable equipment.
One or more environmental cultures were found to be MRSA-positive in the rooms of 10 patients (59%), while Clostridioides difficile and vancomycin-resistant Enterococci were each found in the rooms of two patients. Patients interacted with an average of 2.4 hospital workers and 0.6 portable devices per hour of observation. In a subset of patients, MRSA appeared on the hospital room floors within hours of admission, and was subsequently found on patient beds, high-touch surfaces, and patient socks within 24 hours.
Molecular typing conducted in several patient rooms found that the spa type of the MRSA isolates on the floors was the same as isolates recovered from other sites, but the direct transfer of pathogens to personnel or equipment to high-touch surfaces was not detected.
"Hand hygiene is critical, but we need to develop practical approaches to reduce under-appreciated sources of pathogens to protect patients," senior author Curtis Donskey, MD, an epidemiologist at the Cleveland VA Medical Center, said in a press release from the Society for Healthcare Epidemiology of America (SHEA), which sponsors the journal.
Nov 2 Infect Control Hosp Epidemiol abstract
Nov 2 SHEA press release
Avian flu detected in Russia, Israel, Germany, and UK
In the latest avian flu outbreak developments, Russia and Israel reported more highly pathogenic H5N8 outbreaks in poultry, German detected H5N8 and H5N8 in a few wild birds, and the United Kingdom reported an event involving low-pathogenic H5N2 in poultry.
A small but steady stream of H5N8 outbreaks have been occurring in Russia and Kazakhstan over the past few months, and officials have feared that migratory birds would spread to virus to other locations in Europe.
Russia's latest outbreak began on Oct 19 at a commercial poultry farm in Rostov oblast in the far southwestern part of the country, killing 1,011 and sickening 52,179 of more than 1.1 million susceptible birds. The survivors were slated for culling as part of the outbreak response measures.
Meanwhile, Israel reported two H5N8 outbreaks at turkey farms, one in Hazafon and the other in Haifa. The events began on Oct 29 and Oct 30, respectively, killing 170 of 18,870 birds at the locations. The rest were destroyed.
erman government veterinary officials said avian flu has been detected in wild birds, apparently found dead, in three different states. They include a wild duck in Hamburg, a buzzard in Mecklenburg-Western Pomerania, and various wild birds in Schleswig-Holstein. The virus types included H5N8 and H5N5.
Also, the UK Department for Environment, Food, and Rural Affairs (DEFRA) today said low-pathogenic H5N2 has been identified in an outbreak at a small commercial poultry farm near the city of Deal in Kent. All 480 birds will be euthanized to curb the spread of the virus. An investigation is under way into the source of the virus, and DEFRA said wild birds migrating from mainland Europe during the winter pose a risk of spreading the disease to poultry and other captive birds.
Nov 2 OIE report on H5N8 in Russia
Nov 1 OIE report on H5N8 in Israel
Oct 31 German government statement
Nov 2 DEFRA update