Comparison of detergent-based cleaning, disinfectant-based cleaning, and detergent-based cleaning after enhanced domestic staff training within a source isolation facility

Source isolation facilities should be adequately cleaned to minimise the risk of cross-infection via the environment and fomites. The aim of this study was to compare the effectiveness of cleaning with detergent, cleaning with detergent followed by sodium hypochlorite and cleaning with detergent after enhanced training for domestic staff within isolation facilities in a district general hospital in southern England. Frequent 'hand touch' sites in two isolation rooms were sampled, using contact plates. A total of 567 plates were collected. Bacterial total viable counts (TVCs) and environmental meticillin-resistant Staphylococcus aureus (MRSA) were used as surrogate markers to compare the efficacy of the cleaning methods. The results indicate that cleaning with water and detergent followed by sodium hypochlorite achieved significantly lower TVCs for most sampling sites, but only significantly lower environmental MRSA detections from a minority of sample sites. No one method of cleaning consistently eliminated MRSA from the environment. These results provide some preliminary evidence for the use of detergent and hypochlorite cleaning within source isolation facilities.