Infection Control & Hospital Epidemiology (2019), 40, 164–170 doi:10.1017/ice.2018.315
Original Article
Effectiveness of antimicrobial hospital curtains on reducing bacterial contamination—A multicenter study
Shik Luk MBBS, MRCP, FRCPath, FHKCPath, FHKAM1, Viola Chi Ying Chow MBChB, MRCP, FRCPath, FHKCPath, FHKAM2, Kelvin Chung Ho Yu BSc3,4, Enoch Know Hsu BSc, MSc3,4, Ngai Chong Tsang MBBS, FRCPath, FHKCPath, FHKAM5,6, Vivien Wai Man Chuang MBBS, FRCPA, FHKCPath, FHKAM6, Christopher Koon Chi Lai MBChB, MRCP, FRCPath, FHKCPath, FHKAM5, Mamie Hui MBChB, MD (CUHK), FRCPath, FHKCPath, FHKAM7, Rodney Allan Lee MBBS, FRCPA, FHKCPath, FHKAM8, Wai Man Lai MBChB, FRCPA, FHKCPath, FHKAM2, Tak Lun Que MBBS, FRCPath, FHKCPath, FHKAM9, Sau Chun Fung MBChB, FRCPA, FHKCPath, FHKAM, MSc10, Wing Kin To MBChB, FRCPA, FHKCPath, FHKAM1, Vincent Chi Chung Cheng MBBS, FRCPath, FHKCPath, FHKAM11
and Andrew Tin Yau Wong MBBS, MSc, MPH, FRCP, FFPH, FHKCP, FHKAM3,4 1Department of Pathology, Princess Margaret Hospital, Hong Kong, China, 2Department of Microbiology, Prince of Wales Hospital, Hong Kong, China, 3Infection Control Branch, Centre for Health Protection, Department of Health, Hong Kong, China, 4Infectious Disease Control Training Centre, Hospital
Authority, Hong Kong, China, 5Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China, 6Chief Infection Control Officer Office, Hospital Authority Head Office, Hong Kong, China, 7Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China, 8Department of Clinical
Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China, 9Department of Clinical Pathology, Tuen Mun Hospital, Hong Kong, China, 10Department of Pathology, United Christian Hospital, Hong Kong, China and 11Department of Microbiology, Queen Mary Hospital, Hong Kong, China
Abstract
Objective: To determine the efficacy of 2 types of antimicrobial privacy curtains in clinical settings and the costs involved in replacing standard curtains with antimicrobial curtains. Design: A prospective, open-labeled, multicenter study with a follow-up duration of 6 months. Setting: This study included 12 rooms of patients with multidrug-resistant organisms (MDROs) (668 patient bed days) and 10 cubicles (8,839 patient bed days) in the medical, surgical, neurosurgical, orthopedics, and rehabilitation units of 10 hospitals. Method: Culture samples were collected from curtain surfaces twice a week for 2 weeks, followed by weekly intervals. Results: With a median hanging time of 173 days, antimicrobial curtain B (quaternary ammonium chlorides [QAC] plus polyorganosiloxane) was highly effective in reducing the bioburden (colony-forming units/100cm2, 1 vs 57; P<.001) compared with the standard curtain. The percentages of MDRO contamination were also significantly lower on antimicrobial curtain B than the standard curtain: methicillin-resistant Staphylococcus aureus, 0.5% vs 24% (P<.001); carbapenem-resistant Acinetobacter spp, 0.2% vs 22.1% (P<.001); multidrug-resistant Acinetobacter spp, 0% vs 13.2% (P<.001). Notably, the median time to first contamination by MDROs was 27.6 times longer for antimicrobial curtain B than for the standard curtain (138 days vs 5 days; P=.001). Conclusions: Antimicrobial curtain B (QAC plus polyorganosiloxane) but not antimicrobial curtain A (built-in silver) effectively reduced the microbial burden and MDRO contamination compared with the standard curtain, even after extended use in an active clinical setting. The antimicrobial curtain provided an opportunity to avert indirect costs related to curtain changing and laundering in addition to improving patient safety.
(Received 30 July 2018; accepted 31 October 2018)
The role of contaminated environment in the transmission of multidrug-resistant organisms (MDROs) is well established.1 Micro- biological studies have reported that MDROs can survive for months on dry hospital surfaces.2 Patient privacy curtains, frequently touched by healthcare workers (HCWs) before and after performing patient care, were frequently contaminated by MDROs, namely
Author for correspondence: Dr Shik Luk, 12/F, Department of Pathology, Block G, Princess Margaret Hospital, Hong Kong, China. E-mail:
sluk@ha.org.hk
Cite this article: Luk S, et al. (2019). Effectiveness of antimicrobial hospital curtains
on reducing bacterial contamination—A multicenter study. Infection Control & Hospital Epidemiology 2019, 40, 164–170. doi: 10.1017/ice.2018.315
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved.
vancomycin-resistant enterococci (VRE) (42%), methicillin-resistant Staphylococcus aureus (MRSA, 22%), and Clostridium difficile (4%).3 In contrast to direct contact with patients, hand hygiene after contact with patient surroundings has often been missed.4 Importantly, more than 90% of privacy curtains were rapidly contaminated within 1 week,5 yet thechangingschedulewas infrequent. Thus, privacy curtains can potentially act as vehicles for MDRO transmission. Studies of drug- resistant Acinetobacter baumannii and group A Streptococcus outbreaks have identified curtains as a potential source of transmission.6–8 In Hong Kong, privacy curtains of general patients residing in public hospitals are changed every 4 weeks; for patients on contact
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