Persistence of microbes
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Transcript of Persistence of microbes
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How long do nosocomial pathogens persist on inanimate surfaces?
A systematic review
Reviewed by Dr. Sayan Chakraborty
MD (JR-2), Dept. of Tropical MedicineCalcutta School of Tropical Medicine
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Author: Axel Kramer
BMC Infectious Diseases BMC series open, inclusive and trusted 2006 6:130
DOI: 10.1186/147123346130© Kramer et al; licensee BioMed Central Ltd.
2006Received: 26 April 2006
Accepted: 16 August 2006Published: 16 August 2006
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BACKGROUND• Global infection control community: ongoing
controversy about the appropriate t/t of inanimate surfaces in hospitals
• Non-antimicrobial detergents/ antimicrobial agents ??
• Parameters to be noted: Type of ward Expected frequency of hand contact with a
surfacePersistence of nosocomial pathogens on surfaces
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METHODS• Search strategy:Reviewed in MedLine on the internet
homepage of the National Library of MedicineStandard textbooks on infection control,
bacteriology and virology• Selecting studies: Reports with experimental
evidence• Interpretation of studies: Pathogens were
grouped according to importance and persistence
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RESULTS• Persistence of bacteria
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RESULTS- Bacteria
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RESULTS - Bacteria• Gram negative persist longer than gram positive• Humid conditions improved persistence• Only Staphylococcus aureus persist longer at low
humidity• Low temperatures, e.g., 4°C or 6°C, also improved
persistence• Test material -no consistent result. However, longer
persistence noted on plastic & steel• Longer persistence with higher inocula, in the
presence of protein, serum, sputum or without dust
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RESULTS- FungiThe presence of serum or albumin, low temp & high humidity lead to longer persistence
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RESULTS - Virus
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RESULTS - Virus
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RESULTS - VIRUS• Viruses of Respiratory tract: a few days• Viruses of GI tract: 2 months• Blood borne viruses eg HBV or HIV > 1 week• High humidity: Entero- & Rhinovirus• Low humidity: HSV & HAV• Low temp: Astro-, Adeno-, Polio, HSV & HAV• Type of material inconsistent• Non-porous substance- Influenza; Fomica & gloves-
RSV; Telephone receiver- FCV• Longer persistence in fecal suspension & higher
inoculum
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DISCUSSION• Factors influencing higher persistence:Low temperatureHigh humidityHigher inoculumType of surface & suspension medium –
inconsistent
• Cryptosporidium species survive on dry surfaces for only 2 hours
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HAND HYGIENE• Transmission to hands: Escherichia coli (100%) Salmonella spp. (100%) Staphylococcus aureus (100%) Candida albicans (90%) Rhino virus (61%) HAV (22% – 33%) Rota virus (16%).• Contaminated hands can transfer viruses to 5 more surfaces or
14 other subjects.• Recontaminating of surface, as in HAV.• Compliance rates of healthcare workers in hand hygiene
around 50%
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Common modes of transmission from inanimate surfaces to susceptible patients
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DISCUSSION …. contd• During outbreaks, role of environmental
contamination stronger for Clostridium difficile, MRSA and VRE than for Pseudomonas aeruginosa or Acinetobacter baumannii
• Routine treatment of floors with surface disinfectants - no significant impact
• Disinfection of surfaces in the immediate environment of patients reduce nosocomial infection
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CONCLUSION
• Most nosocomial pathogens persist on inanimate surfaces for weeks or even months
• Disinfection of surfaces in specific patient care areas
• PROPER HAND HYGIENE
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