Controlling MRSA: what is the way forward?

The fall and rise of cleanliness in British healthcare and the nursing contribution

This paper discusses the term ‘cleanliness’ and applies it to healthcare. Ways of achieving cleanliness in premises where healthcare is delivered are explored. It is concluded that although once a world-leader in infection control practice and research, the United Kingdom is now lagging behind other countries. Traditionally hands have been regarded as the main vectors of healthcare-associated infection. However, hands can never be rendered entirely free of micro-organisms, so it is inevitable that healthcare-associated infection will always be a challenge. Decontamination of the healthcare environment, its fixtures, fittings and clinical equipment are also of pivotal importance in maintaining cleanliness, controlling infection and regaining consumer confidence in healthcare. Nurses play a major role in ensuring that appropriate decontamination processes and procedures are in place to meet required standards. To do so they must receive the appropriate education and training.

Efficacy of super-oxidized water fogging in environmental decontamination

The efficacy of decontamination using Sterilox fog was assessed against meticillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii. Ceramic tiles were inoculated with the test organisms and, once dried, were subjected to Sterilox fogging using a stationary vaporizing machine sited at a distance of 3m for 10 min and then left for a further hour. In a second experiment using the same organisms, the first 10-min fogging period was followed by a directed fogging period of 30s at a distance of 1m. Organisms were cultured from the tiles, plated on to tryptone soya agar and incubated for 48 h. Initial counts of approximately 10(9) colony-forming units/mL for both organisms were reduced approximately 10(4) fold for MRSA and 10(5.8) fold for A. baumannii when using a single fogging. The second fogging resulted in 10(6.8)-fold reductions for both organisms. Sterilox fog is safe and simple to use, and can reduce levels of nosocomial pathogens by a factor of almost 10(7). It is worthy of clinical evaluation in clinical settings to determine whether it maintains its microbicidal effects against a variety of organisms on different surfaces.