Environmental surfaces like bed rails, bed linen, and medical equipment are frequently contaminated by pathogens such as MRSA, C. difficile, and Acinetobacter. These organisms can survive on surfaces for weeks or months and only a few bacteria are needed to cause infection. High-touch surfaces near patients are most likely to be contaminated. Routine cleaning and disinfection with an EPA-registered disinfectant with tuberculocidal activity is recommended to remove pathogens from the environment. Proper cleaning methods and schedules help control the spread of infection in healthcare facilities.

1. ENVIROMENTAL
CONTROL

2. Environmental Contamination
• Patients with pathogens such as methicillin-
resistant S. aureus (MRSA), Clostridium
difficile, vancomycin-resistant enterococci
(VRE), and Acinetobacter frequently
contaminate environmental surfaces .
• These organisms can remain viable in the
environment for weeks or months

3. Survival time Infectious dose
MRSA 7 days to 7 months 4 cfu’s
Acinetobacter 3 days to 5 months 250 cfu’s
C.difficile 5 months 7 spores
VRE 5 days to 4 months <103 cfu’s
Norovirus 8 hours to 7 days 10-100 virions
Kramer, BMC Infect Dis, 2006; Dancer SJ, LID 2008; Chiang, Crit Care Med 2009;
Wilcox M, 2010; Larson, Lancet 1978; Kjerulf et al, APMIS 1998
Properties of hospital pathogens

4. Examples of Contaminated Environmental
Surfaces
• Items frequently
contaminated near patients
include:
• Bed rails
• Bed linen
• Over-bed tables
• Blood pressure cuffs
• Intravenous pumps
• Nurse call buttons
• Urinary collection bags

5. Carling et al, JHI 2010
Frequently touched surfaces!

6. Environmental Control
 Use EPA-registered disinfectants that have tuberculocidal
activity . It will act against the pathogens most likely to contaminate
the patient-care environment.
 Use in accordance with manufacturer's instructions , for dilution and
contact time .
6

7. Cleaning
Is the removal of adherent visible soil, blood,
and other debris from surfaces
Generally accomplished with water and
detergents
Removes or eliminates the reservoirs of potential
pathogenic organisms
Cleaning should be done on a regular basis to
remove soil and dust

8. Disinfection and Sterilization …
Disinfection
is the destruction of harmful microorganisms, other
than bacterial spores, on inanimate objects by the use
of a chemical agent
Sterilization
Is the process by which all forms of microbial life,
including bacteria, viruses, spores and fungi are
destroyed

9. Cleaning Schedules
Keep housekeeping surfaces visibly clean on regular basis
Starting from non- infected area and keep infected area at last
Clean up spills promptly
Clean and disinfect high-touch surfaces, such as doorknobs,
bed rails, light switches, and surfaces in and around toilets on
a more frequent schedule
Use EPA -registered hospital disinfectant
Clean walls, blinds, and window curtains in patient-care areas
when visibly soiled or dusty
After last procedure of day, mop the floors

10. Cleaning of some pathogen
For MDRO,MRSA use routine cleaning
In case of Clostridium difficile spores, use
hypochlorite-based products for disinfection
(Clorox 1:10).
For VRE vigorous cleaning is required

11. Blood and Body Fluids Spills
Promptly clean and disinfect spills of blood and other
potentially infectious materials.
 Use protective gloves and other personal protective equip.
 Use CHLORINE RELEASING DISINFECTANT (active against HIV
or HB)
 Wet blood: Presept powder (GRANULES )
 Dried blood: Presept tablet diluted @ 10,000 ppm
 Contact time: 2 minutes
 Scoop and dispose in yellow bag
 Clean with hot water and disinfectant

12. Terminal Cleaning of Rooms
Discard all disposable items in accordance with the
policy on disposal of infectious wastes.
Thoroughly clean all horizontal surfaces of furniture,
mattress covers and patient care equipment with a
disinfectant-detergent .
Wet-vacuum or wet-mop all floors with a disinfectant-
detergent solution.
Clean walls and blinds. Change curtains.

13. Separate DIRTY ITEMS FROM CLEAN ITEMS

14. Remember…
Everything you
touch has been
touched by
someone else!
KING KHALID UNIVERSITY HOSPITAL
INFECTION CONTROL DEPARTMENT