Movement of a Viral Surrogate from Restrooms to Public Areas in a Hospital

Abstract

Contaminated fomites are a cause of concern for the spread of health care-associated infections (HAI's). Previous research has placed emphasis on fomites in patient rooms and patient bathrooms with limited focus on the spread of microorganisms on fomites in non-patient care areas. The present study monitored surrogate virus tracer (MS2 coliphage) spread from public restrooms (used by staff and visitors) to waiting areas in a surgical ward in a Level I Trauma Center. The coliphage (virus) MS2 was added onto the entrance door handle of male and female public restrooms. Four hours later, various surfaces in the restroom and waiting area were sampled. Sampling periods were conducted in duplicate consisting of before cleaning, cleaning with the current cleaning product and procedure and cleaning with an intervention (inclusion of a bleach based disinfectant wipe) in addition to the current cleaning product and procedures. Before cleaning took place, the virus tracer was detected on all 21 of the sites sampled in the restrooms and 5/9 sites within the hallway ranging from 15-50 feet from the restroom. These results indicated that a virus could spread from public restrooms to other sites in the restroom and to locations in the surgical ward. The addition of a bleach based disinfectant wipe reduced the virus by another 90% compared to current disinfecting and cleaning procedures. Coliphage MS2 has been used as a model virus for norovirus and rhinovirus since they exhibit similar survival on fomites and resistance to disinfectants. The data generated can be used in quantitative microbial risk assessment models to assess the risk of pathogens spreading from restrooms to patient waiting areas and patient care areas in healthcare settings. Based on this study, facilities should consider broadening their cleaning and disinfection protocols to include both patient care and non-patient care areas.