Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study.

This study aimed to evaluate the potential impact of one additional cleaner by using microbiological standards (aerobic colony counts) and the presence of Staphylococcus aureus including MRSA. Enhanced cleaning was associated with a 32.5% reduction in levels of microbial contamination at handtouch sites when wards received enhanced cleaning. Near-patient sites (lockers, overbed tables and beds) were more frequently contaminated with MRSA/S. aureus than sites further from the patient. Genotyping identified indistinguishable strains from handtouch sites and patients, supporting the possibility that patients acquired MRSA from environmental sources.. There was a 26.6% reduction in new MRSA infections on the wards receiving extra cleaning, despite higher MRSA patient-days and bed occupancy rates during enhanced cleaning periods. Adjusting for MRSA patient-days and based upon nine new meticillin-resistant S. aureus infections seen during routine cleaning, we expected 13 new infections during enhanced cleaning periods rather than the four that actually occurred. Clusters of new MRSA infections were identified 2 to 4 weeks after the cleaner left both wards. Enhanced cleaning saved the hospital £30,000 to £70,000. BMC Med. 2009 Jun 8;7:28.