Are hygiene standards useful in assessing infection risk?

Liza F. White, Stephanie J. Dancer, Chris Robertson, John McDonald, National Health Service (Funder)

Research output: Contribution to journalArticle

84 Citations (Scopus)
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We monitored the surface level cleanliness of a five-bedded surgical intensive care unit (SICU) over a ten-week period in order to evaluate proposed hygiene standards.Ten environmental sites within SICU were sampled twice weekly along with collection of clinical and patient activity data. The standards designate aerobic colony counts (ACCs) >2.5cfu/cm2 from hand-touch sites and the presence of Staphylococcus aureus as hygiene failures. Nearly a quarter of 200 samples failed the standards, mostly from hand-touch sites on curtains, beds and medical equipment. The total number of fails each week was associated with bed occupancy (p=0.04), trending towards association with SICU-acquired infections (p=0.11). Environmental S.aureus was associated with the proportion of beds occupied (p = 0.02). Indistinguishable genotypes were found between patient and environmental staphylococci, with timescales supporting staphylococcal transmission in both directions. Hygiene standards based on microbial growth levels and the presence of S.aureus reflect patient activity and provide a means to risk manage infection. They also exposed a staphylococcal reservoir that could represent a more tangible risk to patients. Standards for surface level cleanliness deserve further evaluation.
Original languageEnglish
Pages (from-to)381-384
Number of pages3
JournalAmerican Journal of Infection Control
Issue number5
Publication statusPublished - Jun 2008


  • hospital cleaning
  • clinical environment
  • staphylococci
  • hospital-acquired infection
  • intensive care unitrunning head
  • hygiene standards and infection risk


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