The Occurrence and Control of Pathogens on Fomites

Abstract

Microbes survive for an extended period of time on fomites. With new strains of pathogens constantly emerging, it is important to understand their survival and spread and to evaluate the efficiency of new disinfection methods. The purpose of this study was to determine the occurrence of pathogens on fomites, and evaluate different disinfection methods (household bleach and steam vapor). Fomites were sampled in a variety of environments for the presence of pathogens including methicillin intermediate- and resistant- Staphylococcus aureus, Clostridium difficile, Penecillium brevi-compactum, Alternaria alternata and novel H1N1 influenza A. Samples were assayed using both cultural and genetic techniques to determine the microbial occurrence. In disinfection studies, samples were collected before and after disinfectant application. Steam vapor was effective at reducing microbial occurrence by>90% with a minimal contact time of 10-20 seconds on hospital fomites. The material and shape of the surface had an effect on the reduction rate, due to access of the disinfecting agent. In addition, low levels of initial contamination limited the reduction rate. Many surfaces had a starting contamination level of less than 3 log10 and after disinfection the contamination levels, in 69% of the samples, were at or near the limit of detection. This suggests a higher reduction is feasible. Household bleach reduced the presence of mold spores and mycelium by >99% on gypsum-wall board. Reduction rates were influenced by the growth stage of mold, with the mycelium requiring additional disinfectant application to achieve the 99% reduction rate. Novel H1N1 influenza A was not recovered on any surfaces in day care facilities and elementary schools. This is consistent with previous studies looking at H1N1 influenza occurrence in similar environments, though it is different from H3N2 influenza A studies. Survival differences among varying influenza strains are expected to have an impact on pathogen spread and human health risks. Differences can be quantitatively evaluated and used to develop more advanced risk assessment models. Steam vapor and household bleach are effective at reducing risks of pathogens in the environment and are critical interventions in an overall strategy to minimize exposure and prevent disease.