High-touch surfaces can pose risks in long-term care

In their infection control regimen, hospitals are laser-focused on “high-touch” surfaces such as bed rails, tray tables and other items at high risk for transmitting infectious diseases.

But, according to a recent study, more than 90% of high-touch surfaces in long-term care facilities are contaminated with fecal matter or failed tests that detect organic debris that is associated with diarrheal illnesses and deaths. The study of 11 long-term care facilities in South Carolina was published in the American Journal of Infection Control.

Researchers say the results could help long-term facilities monitor their cleaning practices and refine infection prevention plans to better protect patients.

In the study, researchers measured the presence of three factors to evaluate the cleanliness of a minimum of 30 surfaces in each of the 11 facilities: adenosine triphosphate (ATP), a bioluminescent chemical reaction that indicates the presence of organic material; norovirus, a very contagious virus that causes vomiting and diarrhea; and crAssphage, a recently discovered DNA bacteriophage that is a promising tool for detecting human fecal contamination.

According to the results:

• All surfaces were contaminated with crAssphage or high levels of organic debris.
• The highest levels of ATP and/or crAssphage were in patient rooms and public areas.
• All 337 surfaces tested negative for norovirus.

According to the study, handrails, equipment controls and patient beds were four times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails, and tables and chairs in patient lounges also tested positive for high levels of both ATP and crAssphage, the study shows.

The study shows that hygienic monitoring was effective in identifying areas where cleaning efforts could be strengthened.