Source avec lien : Journal of Hospital Infection, . 10.1016/j.jhin.2022.03.002
Les organismes multirésistants (MDRO) (Staphylococcus aureus résistant à la méticilline, entérocoques résistants à la vancomycine, espèces d’Acinetobacter MDR, organismes Gram-négatifs produisant des bêta-lactamases à spectre étendu), Clostridioides difficile, agents pathogènes respiratoires viraux et infections associées aux soins (IAS) sont des préoccupations majeures dans les établissements médicaux. L’objectif de cette étude est d’évaluer la formation, la charge de travail, les surfaces et les pièces d’équipement médical nettoyées par poste, la durée de travail sur chaque surface, la manière de nettoyer, la supervision, le statut des MDRO et des HAI et la mesure de l’efficacité dans la réduction des MDRO et des HAI chez les patients et sur les surfaces.
Background Multiply drug-resistant organisms (MDROs) (meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococcus, MDR Acinetobacter species, extended-spectrum beta-lactamase-producing Gram-negative organisms), Clostridioides difficile, viral respiratory pathogens and healthcare-associated infections (HAIs) are major concerns in medical facilities. Aim To assess Environmental Service Workers’ (ESWs) training, workload, surfaces and pieces of medical equipment cleaned per shift, how long they worked on each surface, how they cleaned, supervision, MDRO and HAI status, and measurement of effectiveness in reducing MDROs and HAIs in patients and on surfaces. Methods CINAHL, Cochrane CENTRAL Register of Controlled Trials, EMBASE, Medline, and Scopus were searched to June 28, 2021 (no language/date limits) for hospitals and acute/long term care facilities; disinfection, decontamination, antisepsis, bleach, cleaning, copper treatment of surfaces/textiles, hydrogen peroxide, quaternary ammonium compounds, ultra-violet rays, antimicrobial-treated surfaces and RCTs. Findings and Conclusions Fourteen c-RCTs provided data on a series of interventions. Ten trials focused on reducing patient infections from MDROs/HAIs and four found significant reductions in patient infection rates with strategies including bleach, quaternary ammonium detergents, ultraviolet lights and hydrogen peroxide vapour. We found minimal information was provided on ESW numbers, MDRO/HAI status, workload, numbers of surfaces and objects cleaned/shift, and effects of training on improving effectiveness. Our findings would suggest detailed evaluations of effects of training and disinfection activities for individuals and teams of ESWs are needed.