---
title: "The Ugly Truth: 24/7, 365 = the optimal time for bacterial growth"
description: "The Ugly Truth: 24/7, 365 = the optimal time for bacterial growth"
---

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## The Ugly Truth: 24/7, 365 = the optimal time for bacterial growth

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568ace5fd63b5f29287978/1498845262471//img.png.com/static/595689fc9de4bbc892200518/t/59568ace5fd63b5f29287979/1498843854005/1000w/>

The ugly truth is despite our best efforts hospital  
 associated infections (HAIs) continue to occur.   Thanks to improved efficacy testing methods,  
 Chemical manufacturers have certainly done their part in developing  
 disinfectants that can kill virtually any pathogen known to man.  Environmental Services has worked diligently  
 to implement these products, train their staff and ensure through the use of  
 cleaning validation tools that we are in fact cleaning the surfaces.   As we know that contaminated hands are still  
 likely the largest contributor to transmission, Infection Prevention and  
 Control has put a strong focus on Hand Hygiene in order to improve compliance  
 rates.

Why then are we still seeing transmission?

Aside from the fact that Hand Hygiene rates are still  
 dismal, I think the unfortunate truth is we still are not cleaning (aka killing  
 bugs) effectively.  By this, I am not  
 meaning that our Environmental Services team is doing a poor job of  
 cleaning.  Regardless of country or  
 region, what do we all have in common?  I  
 think we can agree that would be limited or dwindling budgets.  We are all asked to do more with less.  BUT, when it comes to effective cleaning and  
 disinfection we need both the appropriate amount of time and the right number  
 of people to do it.  Cutting back on time  
 and people forces staff to cut corners and cutting corners in the healthcare  
 world leads to adverse patient events (e.g. HAIs). 

Now go and read the article published in AJIC by Schmidt  
 et al ([AJIC 2012;40:907-912](http://www.ncbi.nlm.nih.gov/pubmed/22361357)).  This  
 research team investigated the bacterial burden associated with bed rails and  
 how disinfection helps to minimize the bacterial burden thereby reducing the  
 chance for transmission.  Makes perfect  
 sense doesn’t it?  We know that cleaning  
 and disinfection reduces pathogens on environmental surfaces which has a direct  
 impact on hand contamination... etc, etc... As expected, the results showed that after cleaning and disinfection the  
 microbial burden found on the bed rails was reduced by at least 95%.  That’s pretty darn good!

However, they also looked at what happens to the bacterial  
 burden after disinfection took place.   
 Within 6.5 hrs after cleaning, the bacterial burden had rebounded back  
 by 30 – 40%.  In fact, when using a  
 standard of 250 CFU/100 cm as the level of contamination considered “safe”,  
 within 2hrs after cleaning the contamination on the bed rails exceeded that  
 arbitrary number.   The overall  
 contamination rate was still lower than before the bed rails were cleaned but  
 over the course of 6.5hrs there was a whole whack of reproducing going on!   

Another interesting tidbit is that the researchers  
 compared the results of a standard Quat with a 10-minute contact time to a  
 Quat-Alcohol with a 3-min contact time.   
 And yes, it is true, the faster the contact time the better the kill will  
 be, but in the end bacteria reign supreme!

Let me ask you this.   
 What is the definition of INSANITY?   
 According to Albert Einstein it is doing the same thing over and over  
 again and expecting different results. If our cleaning schedule allows only for Environmental Services to clean  
 patient rooms once per day and while we know this will reduce the environmental  
 bioburden but we also know by the time we get back to clean that same room the  
 next day we are basically back to square one are we insane? Perhaps the answer to solving HAIs is in  
 fact increasing the frequency of cleaning.   
 The more we clean, the more we remove the environmental bioburden which  
 will have a direct impact on hand contamination and HAI transmission. If we follow the data presented in the  
 study, the optimal frequency between cleaning would be every 3 hrs. That may be a bit hard to get buy in for,  
 but, I do know of one facility that has increased their EVS budget to allow for  
 their cleaning staff to clean **ALL** high touch surfaces twice, yes **TWICE**, per  
 day. I’ll be sure to let you know what  
 impact they are seeing to their HAI rates.

In the meantime, who’s brave enough to go ask for more  
 money in order to hire more cleaning staff and increase the frequency of  
 cleaning? 

*Bugging Off!*

Nicole

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