Hospital curtains that surround patients’ beds to provide privacy have been shown to be contaminated and can be a source of pathogens on the HCP hands.3, 4 Since HCP are less likely to perform hand hygiene after contact with inanimate objects such as curtains than direct contact with patients, the pathogens on the curtains can travel to patients via the contaminated hands of HCP. Since privacy curtains are normally not changed until visible contaminated or at some routine frequency (e.g., 3 months), they may represent a reservoir for epidemiologically important healthcare-associated pathogens such as MRSA, VRE, Acinetobacter, C. difficile or other multidrug-resistant pathogens.
We
recently evaluated the ability of a new, improved hydrogen peroxide (1.4%) product
in decontaminating privacy curtains that are contaminated with MRSA, VRE and
other pathogens. This was done by
performing pre-disinfection and post-disinfection cultures of the “grab area” of
the edge of the curtain at a height of approximately 3-6 ft from the floor. After the pre-disinfection cultures had been
collected, the curtain was disinfected by spraying the “grab area” 3 times,
from a distance of 6-8 inches.
The
improved hydrogen peroxide was found to reduce ~98.5% of the pathogens on the
privacy curtains. In the ICU rooms on
patients on Contact Precautions the microbial contamination of the curtains
ranged from 0-341 with an average of 43 MRSA/VRE per Rodac. Post-disinfection the MRSA and VRE were
completely eliminated (100% reduction).
All decontamination
technologies have both advantages and disadvantages. A
major advantage of improved hydrogen peroxide is its rapid action, high
effectiveness and low toxicity. A
disadvantage is it is more expensive than a quaternary ammonium compound in
ready-to-use containers. However, the cost
of decontaminating a privacy curtain with improved hydrogen peroxide (product
costs for 3 sprays per curtain was about $0.01; 2.5 mls per three sprays) would
be far less that removing the curtain and replacing with a new curtain between
patients. Other options to minimize the
risk of curtains as reservoirs for healthcare-associated pathogens include:
eliminate privacy curtains for patients in private rooms (the door would be
used for privacy but would require support of nursing and medical staff); change
curtains at discharge of patients on Contact Precautions; or use an
antimicrobial privacy curtain.
In summary, improved hydrogen
peroxide would be an alternative to decontaminating privacy curtains between
patients. The use of improved hydrogen peroxide could be easily integrated into
healthcare practices where the occupancy is high and fast patient room
turnaround time is critical.
References
1. Weber DJ, Rutala WA, Miller MB, Huslage
K, Sickbert-Bennett E. Role of hospital surfaces in the transmission of
emerging health care-associated pathogens: Norovirus, Clostridium difficile, and Acinetobacter
species. Am J Infect Control 2010;38:S25-33.
2. Otter JA. The role played by
contaminated surfaces in the transmission of nosocomial pathogens. Infect
Control Hosp Epidemiol 2011;32:687-99.
3. Trillis F III EE, Budavich R, Pultz MJ,
Donskey CJ. Contamination of hospital curtains with healthcare-associated
pathogens. Infect Control Hosp Epidemiol 2008;29:1074-6.
4. Neely AN, Maley MP. The 1999 Lindberg
award. 3% hydrogen peroxide for the gram-positive disinfection of fabrics.
Journal of Burn Care & Rehabilitation 1999;20(6):471-7
