Dr Mark Garvey1, Peter Francis Davis Liquorish Wrightson1, Sarah Bashford1, Khushbu Jani1, Tom Farmah1, Caroline Smith1, Dr Martyn Wilkinson1, Dr Elisabeth Holden1
1University Hospitals Birmingham NHS Foundation Trust, United Kingdom
Biography:
Mark is a Consultant Clinical Scientist, Director of the Hospital Infection Research Laboratory and the Clinical Director of Infection Prevention and Control at University Hospitals Birmingham NHS Foundation Trust. Mark has >80 peer reviewed journal articles and has given >100 national/international presentations in the field of Infection Prevention and Control.
Abstract:
Background
Acquisition of Carbapenemase-producing Enterobacterales (CPE) is associated with poor clinical outcome. Contamination of the healthcare environment constitutes an important reservoir of CPEs. Here we describe a yearlong CPE outbreak within a gastroenterology ward and the effect of introducing a new cleaning package.
Methods
A segmented Poisson regression model was used to analyse changes in monthly CPE numbers on a gastroenterology ward from April 2023 to April 2025. A chlorine-based detergent was used for environmental disinfection between 1st April 2023 and 30th September 2024. An alternative cleaning protocol was introduced from 1st October 2024 to 30th April 2025 using peracetic acid for cleaning.
Findings
Between April 2023 and September 2024, there were 60 patient isolates of CPE on the gastroenterology ward. Multiple infection control interventions were put in place to limit the increased CPE incidence, including CPE screening, staff and patient hand hygiene education, enhanced environmental cleaning and temporary ward closure episodes to facilitate additional cleaning of bays and side rooms. On 1st October 2024, peracetic acid was introduced for cleaning and drain disinfection in place of the chlorine-based product. A segmented Poisson regression model suggested that this intervention was associated with a subsequent reduction in CPE numbers (number of CPE = 1; p < 0.0001).
Conclusion
Environmental disinfection with a peracetic acid agent was associated with a significant reduction in CPEs and appeared to be an effective control measure during a large ward outbreak. This study highlights the importance of environmental hygiene in minimising transmission of CPEs.