High-Touch Surfaces in Long-Term Care Facilities Often Contaminated

Findings could help long-term care facilities assess cleanliness of high-touch surfaces and enhance infection prevention and control measures

By HFT Staff
October 3, 2022

Findings from a study published recently in the American Journal of Infection Control (AJIC) provide new insights that could help long-term care (LTC) facilities assess the cleanliness of high-touch surfaces, and thereby enhance infection prevention and control measures designed to prevent serious diarrheal diseases and deaths among their residents. The study evaluated the utility of specific hygienic monitoring tools for assessing levels of microbial contamination on high-touch surfaces in 11 LTC facilities in South Carolina. 

“Our study is among only four conducted to date evaluating environmental hygiene in LTC facilities,” says Jennifer Cannon, the paper’s lead author. “Increasingly, hospitals are performing routine audits of high-touch surface cleanliness, helping to reduce morbidity and mortality among residents. Our results suggest similar auditing programs would benefit LTC facilities when included as part of their infection prevention programs.” 

Diarrheal illnesses caused by norovirus and C. difficile infections (CDI) are among the most frequent healthcare-associated infections in LTC facilities. In the United States, approximately 60 percent of norovirus outbreaks, and more than 50 percent of all healthcare-associated CDI occur in LTC facilities. Both pathogens can be transmitted by environmental surfaces contaminated with fecal matter. 

While environmental monitoring using surface hygiene indicators is a valuable tool to help prevent the spread of infection, there are no standard technologies or methodologies, and many monitoring tools are too expensive to be used routinely. For their study, Dr. Cannon and her colleagues used three tools to evaluate the cleanliness of a minimum of 30 surfaces in each of 11 LTC facilities in South Carolina: adenosine triphosphate (ATP), a bioluminescent chemical reaction that indicates the presence of organic material; norovirus; and crAssphage, a recently discovered DNA bacteriophage that indicates past or present fecal contamination. 




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Topic Area: Infection Control


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