How long do they live on surfaces?

[RNsRWe, ASN, RN]

I read here awhile ago about the lengths of time certain organisms can live on non-porous surfaces. And of course now that I want to find it, I haven't!

Anyway, does anyone know for sure how long MRSA and C-diff can survive (and stay viable) this way? Sometimes I wonder about patients who are on isolation for one of them, then their labs say they're clean, so they are OFF isolation...but their rooms haven't been cleaned, just the isolation tags removed. So I wonder what my likelihood of picking it up is??

[lpnflorida]

As long as you are practicing universal precautions on all patients, this should not be an issue. When in doubt, wash your hands with soap this way whether it is mrsa or c-dif you are covered.

Does this mean I am not one of the first people to say to a pregnant staff member "I will go in there or take that patient". Call it the mother hen in me. I realize logically they and the baby are safe, but none the less I still protect them on the just in case.

[mama_d, BSN, RN]

http://www.infectioncontroltoday.com/articles/6b1feat2.html

"In a systematic review of the literature, German researchers explored the ability of infectious organisms to survive on inanimate surfaces.1 They found that most gram-positive bacteria, including vancomycin-resistant enterococcus (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and Streptococcus pyogenes can survive for months on dry surfaces. “In general, there was no obvious difference in survival between multiresistant and susceptible strains of Staphylococcus aureus and Enterococcus spp.,” the authors write. “Only in one study was such a difference suggested, but the susceptible strains revealed a very brief survival as such. Many gram-negative species, such as Acinetobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Serratia marcescens, or Shigella spp. can survive on inanimate surfaces even for months. These species are found among the most frequent isolates from patients with nosocomial infections. A few others, such as Bordetella pertussis, Haemophilus influenzae, Proteus vulgaris, and Vibrio cholerae, however, persist only for days. Mycobacteria — including Mycobacterium tuberculosis and spore-forming bacteria, including Clostridium difficile — can also survive for many months on surfaces.”

Kinda scary, ain't it?

[Jolie, BSN]

As long as you are practicing universal precautions on all patients, this should not be an issue. When in doubt, wash your hands with soap this way whether it is mrsa or c-dif you are covered.

With c-diff universal precautions may not be sufficient. Spores are not killed by standard cleaning, and may live on dry surfaces (bed rails, tables, clothing, etc.) for months, according to this article:

C. diff bacteria are very sensitive to oxygen. But C. diff spores are another matter. They are nearly indestructible and can survive for months on dry surfaces. The CDC recommends disinfecting surfaces with bleach, because the usual hospital disinfectants don't affect it.

http://www.webmd.com/news/20080530/c-diff-epidemic-what-you-must-know?page=3

[lpnflorida]

With c-diff universal precautions may not be sufficient. Spores are not killed by standard cleaning, and may live on dry surfaces (bed rails, tables, clothing, etc.) for months, according to this article:

C. diff bacteria are very sensitive to oxygen. But C. diff spores are another matter. They are nearly indestructible and can survive for months on dry surfaces. The CDC recommends disinfecting surfaces with bleach, because the usual hospital disinfectants don't affect it.

http://www.webmd.com/news/20080530/c-diff-epidemic-what-you-must-know?page=3

I understand what you are saying and it makes perfect sense. Again though if it is a concern and as we are suppose to be washing our hands before and after leaving a room, using hand soap on our own hands makes it a moot point. The choice then is hand soap versus the foam cleansers and we all know the foam cleansers do not protect against c-dif.

[RNsRWe, ASN, RN]

As long as you are practicing universal precautions on all patients, this should not be an issue. When in doubt, wash your hands with soap this way whether it is mrsa or c-dif you are covered.

Ah, but there's the thing: it's not a matter of just needing to wash your hands between patients; if that was the case, then why bother gowning and gloving for isolation patients? Why would not just washing up well afterwards be sufficient? It's because you then carry the risk of infecting yourself as well as potentially someone else by whatever got stuck on your clothes, brushed on your forearm, whatever.

So I have this isolation patient who is on isolation for two weeks with c-diff. Then results come back: no c-diff. Patient is "off" isolation. But the room hasn't been changed, housekeeping doesn't put the patient in the hall and then scrub floor to ceiling. Therefore whatever has been living on every single surface in that room (think pumps, vacs, nightstands, overbed tables, chairs, etc) is still very much there.

Handwashing alone isn't going to cut it if BEFORE the isolation was dc'd I had to gown and glove...and now I don't. And neither does anyone else who walks into that room, picks up something from the bedside table (that has been there for days) and places it on the nurses' station.

And that scares the crud out of me!

[RNsRWe, ASN, RN]

http://www.infectioncontroltoday.com/articles/6b1feat2.html

"In a systematic review of the literature, German researchers explored the ability of infectious organisms to survive on inanimate surfaces.1 They found that most gram-positive bacteria, including vancomycin-resistant enterococcus (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and Streptococcus pyogenes can survive for months on dry surfaces. "In general, there was no obvious difference in survival between multiresistant and susceptible strains of Staphylococcus aureus and Enterococcus spp.," the authors write. "Only in one study was such a difference suggested, but the susceptible strains revealed a very brief survival as such. Many gram-negative species, such as Acinetobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Serratia marcescens, or Shigella spp. can survive on inanimate surfaces even for months. These species are found among the most frequent isolates from patients with nosocomial infections. A few others, such as Bordetella pertussis, Haemophilus influenzae, Proteus vulgaris, and Vibrio cholerae, however, persist only for days. Mycobacteria-including Mycobacterium tuberculosis and spore-forming bacteria, including Clostridium difficile -- can also survive for many months on surfaces."

Kinda scary, ain't it?

You ain't kidding. Which is why I started wondering about all the icks that get spread between patients because chairs get moved around room to room...tables get switched in the same room...visitors who aren't the most compliant with isolation precautions who then hang onto the nurses' station asking questions, touching things.

I'm a little germaphobic, but still....seems to me that those nasty critters you described above are willing to last well into the time we've become comfortable that something is "clean"!

[lpnflorida]

Sounds like a point to bring up to housekeeping supervisors and also to discuss with your infectious disease nurse specialist.

Personally, having worked for 30 years around germs, having not contracted anything from work. I will not be losing sleep over it.