Assessment of surface cleaning and disinfection in neonatal intensive care unit

Mahfoud Chiguer; Adil Maleb; Rim Amrani; Naima Abda; Zayneb Alami

doi:10.1016/j.heliyon.2019.e02966

Assessment of surface cleaning and disinfection in neonatal intensive care unit

Heliyon. 2019 Dec 5;5(12):e02966. doi: 10.1016/j.heliyon.2019.e02966. eCollection 2019 Dec.

Authors

Mahfoud Chiguer^{1

2}, Adil Maleb³, Rim Amrani⁴, Naima Abda⁵, Zayneb Alami^{1

6}

Affiliations

¹ Department of Pharmacy and Clinical Pharmacology, Mohammed VI University Hospital, Oujda, Morocco.
² Department of Biochemistry and Biotechnology, Faculty of Science, Mohammed First University, Oujda, Morocco.
³ Laboratory of Microbiology, Mohammed VI University Hospital/Faculty of Medicine and Pharmacy (University Mohammed the First), Oujda, Morocco.
⁴ Department of Neonatology Intensive Care Unit, Mohammed VI University Hospital, Medical School, University Mohammed First, Oujda, Morocco.
⁵ Department of Epidemiology, Medical School, University Mohammed First, Oujda, Morocco.
⁶ Department of Pharmacology, Medical School, University Mohammed First, Oujda, Morocco.

Abstract

Background: Surveillance for healthcare-associated infections (HAI) is a priority in the neonatal intensive care unit (NICU), given the critical immune status of patients. The aim of this study was to assess surface bacterial contamination before and after improving cleaning and disinfection practices.

Materials and methods: This was a cross-sectional study conducted in March 2018. Surface samples were taken from the same areas in three steps: after cleaning, after "improved" cleaning, and after terminal disinfection using hydrogen peroxide vapor (VHP). Sampling and culture was carried out according to standard ISO14698-1: 2004. Results interpretation was based on the thresholds defined by good hospital pharmacy practice. Statistical analysis was performed by SPSS 21.0 and a P-value < 0.05 was considered to be significant.

Results: In total, 290 samples were taken from different zones: fixed equipment (69%), aseptic washbasins (12%), pneumatic system (9%), computer equipment (6%) and mobile equipment (4%). Prevalence of non-compliances after cleaning and disinfection was 75%, 10% after "improved" cleaning, and 0% after automated VHP (P < 0.0001). Median of CFU was 24[EI (0-625)] after standard cleaning, 2[EI (0-35)] after "improved" cleaning and 0 [EI (0-3)] after VHP (P < 0.0001). Isolated germs werecoagulase-negative Staphylococcus (31.2%), Acinetobacter baumannii (26%), Staphylococcus aureus (19.5%), Pseudomonas aeruginosa (9%), Klebsiella pneumoniae (9%), E. coli (4%) and Enterobacter sp (1.3%).

Conclusion: Improved cleaning and disinfection practices associated to VHP give microbiological satisfactory results. It is important to educate cleaning staff for effective surface cleaning and disinfection operations to control HAI.

Keywords: Cleaning and disinfection practices; Health profession; Healthcare-associated infections; Hydrogen peroxide vapor; Infectious disease; Microbiology; Neonatal intensive care unit.