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1212. Environmental Contamination Characterization of Two Outpatient Clinics
BACKGROUND: Environmental contamination in outpatient clinics is poorly understood. METHODS: We performed a microbiological analysis of surfaces in wound and pulmonary outpatient clinics at a tertiary care center. Cultures were obtained with pre-moistened cellulose sponges from three locations (Exam...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809275/ http://dx.doi.org/10.1093/ofid/ofz360.1075 |
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author | Warren, Bobby G Turner, Nicholas A Smith, Becky A Addison, Rachel Marden, Samantha Weber, David J Rutala, William Anderson, Deverick J |
author_facet | Warren, Bobby G Turner, Nicholas A Smith, Becky A Addison, Rachel Marden, Samantha Weber, David J Rutala, William Anderson, Deverick J |
author_sort | Warren, Bobby G |
collection | PubMed |
description | BACKGROUND: Environmental contamination in outpatient clinics is poorly understood. METHODS: We performed a microbiological analysis of surfaces in wound and pulmonary outpatient clinics at a tertiary care center. Cultures were obtained with pre-moistened cellulose sponges from three locations (Exam bed/chair, patient chair, physician area/chair) before and after clinic days. Sponges were combined with 1% Tween20-PBS and mixed in the Seward Stomacher. The homogenate was centrifuged and all but 5 mL of the supernatant was discarded. Samples were plated on Sheep’s blood agar and selective media for S. aureus, Enterococcus spp. and Gram-negative bacteria. CFU was determined by counting the number of colonies on each plate and using dilution calculations to calculate the CFU of the original ~5 mL homogenate. The total sample areas in the wound and pulmonary clinic were 12,735 cm(2) and 16,400 cm(2), respectively. RESULTS: A total of 300 samples were obtained over 90-days. Median total room CFU was 7,918 (IQR 2,939–18,855) (Figure 1). Median CFU for the examination area, patient area and physician areas were 2090 (537–10508), 1524 (573–4605) and 960 (371–2183), respectively (Figure 2). The proportions of samples positive for S. aureus, Enterococcus spp. and Gram-negative bacteria were 5.0, 3.3 and 7.7%, respectively (Table 1). In general, median total CFU increased during the clinic day (median CFU before the clinic day 6883 (2937–14983) vs. median after clinic day=10351 (3484–21263) (Figure 3). Environmental bioburden was higher in the wound clinic than the pulmonary clinic (median 18206 CFU [IQR 10048–25037) vs. 3764 [IQR 1452–6671], P < 0.001) (Figure 1). The average number of patients seen in the wound clinic per clinic day was greater than the pulmonary clinic (3.8 vs. 2.2, P < 0.001). CONCLUSION: Outpatient clinic rooms were contaminated with clinically important pathogens. Contamination varied by environmental location and increased as the clinic day progressed. Higher contamination was seen in the wound clinic possibly due to higher patient volume vs. increased environmental contamination that occurs while giving wound care. Wound care clinics may need to focus on more detailed cleaning to reduce environmental contamination and the risk of pathogen transmission in at-risk patients. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6809275 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68092752019-10-28 1212. Environmental Contamination Characterization of Two Outpatient Clinics Warren, Bobby G Turner, Nicholas A Smith, Becky A Addison, Rachel Marden, Samantha Weber, David J Rutala, William Anderson, Deverick J Open Forum Infect Dis Abstracts BACKGROUND: Environmental contamination in outpatient clinics is poorly understood. METHODS: We performed a microbiological analysis of surfaces in wound and pulmonary outpatient clinics at a tertiary care center. Cultures were obtained with pre-moistened cellulose sponges from three locations (Exam bed/chair, patient chair, physician area/chair) before and after clinic days. Sponges were combined with 1% Tween20-PBS and mixed in the Seward Stomacher. The homogenate was centrifuged and all but 5 mL of the supernatant was discarded. Samples were plated on Sheep’s blood agar and selective media for S. aureus, Enterococcus spp. and Gram-negative bacteria. CFU was determined by counting the number of colonies on each plate and using dilution calculations to calculate the CFU of the original ~5 mL homogenate. The total sample areas in the wound and pulmonary clinic were 12,735 cm(2) and 16,400 cm(2), respectively. RESULTS: A total of 300 samples were obtained over 90-days. Median total room CFU was 7,918 (IQR 2,939–18,855) (Figure 1). Median CFU for the examination area, patient area and physician areas were 2090 (537–10508), 1524 (573–4605) and 960 (371–2183), respectively (Figure 2). The proportions of samples positive for S. aureus, Enterococcus spp. and Gram-negative bacteria were 5.0, 3.3 and 7.7%, respectively (Table 1). In general, median total CFU increased during the clinic day (median CFU before the clinic day 6883 (2937–14983) vs. median after clinic day=10351 (3484–21263) (Figure 3). Environmental bioburden was higher in the wound clinic than the pulmonary clinic (median 18206 CFU [IQR 10048–25037) vs. 3764 [IQR 1452–6671], P < 0.001) (Figure 1). The average number of patients seen in the wound clinic per clinic day was greater than the pulmonary clinic (3.8 vs. 2.2, P < 0.001). CONCLUSION: Outpatient clinic rooms were contaminated with clinically important pathogens. Contamination varied by environmental location and increased as the clinic day progressed. Higher contamination was seen in the wound clinic possibly due to higher patient volume vs. increased environmental contamination that occurs while giving wound care. Wound care clinics may need to focus on more detailed cleaning to reduce environmental contamination and the risk of pathogen transmission in at-risk patients. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809275/ http://dx.doi.org/10.1093/ofid/ofz360.1075 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Warren, Bobby G Turner, Nicholas A Smith, Becky A Addison, Rachel Marden, Samantha Weber, David J Rutala, William Anderson, Deverick J 1212. Environmental Contamination Characterization of Two Outpatient Clinics |
title | 1212. Environmental Contamination Characterization of Two Outpatient Clinics |
title_full | 1212. Environmental Contamination Characterization of Two Outpatient Clinics |
title_fullStr | 1212. Environmental Contamination Characterization of Two Outpatient Clinics |
title_full_unstemmed | 1212. Environmental Contamination Characterization of Two Outpatient Clinics |
title_short | 1212. Environmental Contamination Characterization of Two Outpatient Clinics |
title_sort | 1212. environmental contamination characterization of two outpatient clinics |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809275/ http://dx.doi.org/10.1093/ofid/ofz360.1075 |
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