Monitoring environmental cleanliness on two surgical wards

Ten hand-touch sites were screened weekly on two surgical wards over two consecutive six-month periods. The results were analysed using hygiene standards, which specify 1) an aerobic colony count (ACC) >2.5cfu/cm2, and 2) presence of coagulase-positive staphylococci, as hygiene failures. Sites most often failing the standards were beds and hoist (64%: 33 of 52 weeks), bedside lockers (62%: 32 of 52) and overbed tables (44%: 23 of 52). Methicillin-susceptible/resistant Staphylococcus aureus (MSSA/MRSA) were more often recovered from lockers, overbed tables and beds. Recovery of MSSA/MRSA at any site was significantly associated with an ACC>2.5cfu/cm2 from that site (p=0.001; OR: 3.35 (95% CI 1.79, 6.28)). In addition, total ACC's>2.5cfu/cm2 each week were significantly associated with weekly bed occupancies >95% (p=0.0004; OR: 2.94 (95% CI 1.44, 6.02)). Higher microbial growth levels from hand-touch sites reflect weekly bed occupancies and indicate a risk for both resistant and susceptible S.aureus. These organisms are more likely to be recovered from near-patient sites on the ward.