Focus on High-Touch Surfaces at Long-Term Care Facilities

Diarrheal illnesses caused by norovirus and C. difficile infections are among the most commonly reported outbreaks in long-term care (LTC) facilities. A new study published last week in the American Journal of Infection Control found that most of the high-touch surfaces in LTC facilities analyzed by researchers tested positive for pathogens that could cause infections.

Researchers evaluated the cleanliness of 30 surfaces in 11 LTC facilities in South Carolina using adenosine triphosphate (ATP) and crAssphage, a recently discovered DNA bacteriophage that indicates past or present fecal contamination. Most (90%) of the surfaces the researchers tested were positive for crAssphage or had organic material levels that resulted in failing ATP cleanliness scores.

Comparing data from the 11 facilities, the investigators identified the types of surfaces and locations most likely to be contaminated by organic or fecal material:

• Handrails and equipment controls were four times more likely to have high levels of crAssphage than other surfaces and locations.
• Patient bed handrails as well as tables and chairs in patient lounges had high levels of both ATP and crAssphage.
• Hallways and patient beds were the facility areas most likely to have high levels of crAssphage.

The researchers found surfaces touched by patients and visitors were twice as likely to have high levels of ATP compared to those touched primarily by nursing and janitorial staff or by patients alone.

“This study provides valuable new information that could help LTC facilities monitor their cleaning practices and refine their infection-prevention plans to better protect patients from serious diarrheal illnesses,” said Linda Dickey, 2022 APIC president.