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High Cost of Foodborne Illness
A single outbreak of foodborne illness can cost a foodservice operation as much as $75,000 in legal fees, medical claims, lost employee wages, cleaning and sanitizing, discarded food supplies, and lost income from negative publicity and/or being shut down. That figure increases dramatically if the incident involves death or serious injury.
National Restaurant Association
By Rupak Datta, MPH; Richard Platt, MD, MS; Deborah S. Yokoe, MD, MPH; Susan S. Huang, MD, MPH
Background
Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40% increased risk of acquisition, presumably through environmental contamination. Subsequently, a cleaning intervention was shown to reduce MRSA and VRE room contamination. We now evaluate the effect of this intervention on the risk of acquiring MRSA and VRE from prior room occupants.
Methods
We conducted a retrospective cohort study of patients admitted to 10 intensive care units at a 750-bed academic medical center during the enhanced cleaning intervention (from September 1, 2006, through April 30, 2008; n = 9449) vs baseline (from September 1, 2003, through April 30, 2005; n = 8203) periods. The intervention consisted of targeted feedback using a black-light marker, cleaning cloths saturated with disinfectant via bucket immersion, and increased education regarding the importance of repeated bucket immersion during cleaning. Intensive care units included medical, cardiac, burn/trauma, general surgery, cardiac surgery, thoracic surgery, and neurosurgery units. We calculated the number of room stays involving the potential for MRSA and VRE acquisition and then assessed the frequency at which eligible patients were exposed to rooms in which the prior occupants had MRSA-positive or VRE-positive status.
Results
Acquisition of MRSA and VRE was lowered from 3.0% to 1.5% for MRSA and from 3.0% to 2.2% for VRE (P < .001 for both). Patients in rooms previously occupied by MRSA carriers had an increased risk of acquisition during the baseline (3.9% vs 2.9%, P = .03) but not the intervention (1.5% vs 1.5%, P = .79) period. In contrast, patients in rooms previously occupied by VRE carriers had an increased risk of acquisition during the baseline (4.5% vs 2.8%, P = .001) and intervention (3.5% vs 2.0%, P < .001) periods.
Conclusions
Enhanced intensive care unit cleaning using the intervention methods may reduce MRSA and VRE transmission. It may also eliminate the risk of MRSA acquisition due to an MRSA-positive prior room occupant.
Authors
Rupak Datta, MPH; Richard Platt, MD, MS; Deborah S. Yokoe, MD, MPH; Susan S. Huang, MD, MPH
Arch Intern Med. 2011;171(6):491-494. doi:10.1001/archinternmed.2011.64
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