Jennifer L Cannon1, Geun Woo Park2, Benjamin Anderson3, Cortney Leone4, Morgan Chao4, Jan Vinjé2, Angela M Fraser4. 1. National Foundation for the Centers for Disease Control and Prevention Inc., Atlanta, GA,; Center for Food Safety, University of Georgia, Griffin, GA; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: flb8@cdc.gov. 2. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA. 3. Center for Food Safety, University of Georgia, Griffin, GA. 4. Food, Nutrition, and Packaging Sciences Department, Clemson University, 206 Poole Agricultural Center, Clemson, SC.
Abstract
BACKGROUND: Norovirus and C. difficile are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities and can be transmitted by contaminated environmental surfaces. Hygienic monitoring tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal contamination can help to identify LTC facility surfaces with cleaning deficiencies. METHODS: High-touch surfaces in 11 LTC facilities were swabbed and tested for contamination by norovirus, a fecal indicator virus, crAssphage, and ATP which detects organic debris. High levels of contamination were defined as log ATP relative light unit values or crAssphage log genomic copy values in the 75th percentile of values obtained from each facility. RESULTS: Over 90% of surfaces tested positive for crAssphage or gave failing ATP scores. Norovirus contamination was not detected. Handrails, equipment controls, and patient beds were 4 times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails and tables and chairs in patient lounges had high levels of both ATP and crAssphage. CONCLUSIONS: Surfaces with high levels of ATP and crAssphage were identified. Quantifying levels of contamination longitudinally and before and after cleaning might enhance infection prevention and control procedures for reducing diarrheal illnesses in LTC facilities.
BACKGROUND: Norovirus and C. difficile are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities and can be transmitted by contaminated environmental surfaces. Hygienic monitoring tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal contamination can help to identify LTC facility surfaces with cleaning deficiencies. METHODS: High-touch surfaces in 11 LTC facilities were swabbed and tested for contamination by norovirus, a fecal indicator virus, crAssphage, and ATP which detects organic debris. High levels of contamination were defined as log ATP relative light unit values or crAssphage log genomic copy values in the 75th percentile of values obtained from each facility. RESULTS: Over 90% of surfaces tested positive for crAssphage or gave failing ATP scores. Norovirus contamination was not detected. Handrails, equipment controls, and patient beds were 4 times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails and tables and chairs in patient lounges had high levels of both ATP and crAssphage. CONCLUSIONS: Surfaces with high levels of ATP and crAssphage were identified. Quantifying levels of contamination longitudinally and before and after cleaning might enhance infection prevention and control procedures for reducing diarrheal illnesses in LTC facilities.
Authors: Ingeborg L A Boxman; Linda Verhoef; Remco Dijkman; Geke Hägele; Nathalie A J M Te Loeke; Marion Koopmans Journal: Appl Environ Microbiol Date: 2011-03-04 Impact factor: 4.792
Authors: Jennifer L Cannon; Leslie Barclay; Nikail R Collins; Mary E Wikswo; Christina J Castro; Laura Cristal Magaña; Nicole Gregoricus; Rachel L Marine; Preeti Chhabra; Jan Vinjé Journal: J Clin Microbiol Date: 2017-05-10 Impact factor: 5.948
Authors: Laura Y Sifuentes; Sonia L M Fankem; Kelly Reynolds; Akrum H Tamimi; Charles P Gerba; David Koenig Journal: Food Environ Virol Date: 2016-08-18 Impact factor: 2.778
Authors: John M Boyce; Nancy L Havill; Diane G Dumigan; Michael Golebiewski; Ola Balogun; Ramo Rizvani Journal: Infect Control Hosp Epidemiol Date: 2009-07 Impact factor: 3.254