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Friday, May 6, 2016

Mattresses – the “elephant” fomite in the room…

Tonight while I write this blog, I am on the eve of a 4-day weekend get-a-way.  I’m excited.  It’s a birthday present.  I’m a lucky girl and have an awesome husband.  But tomorrow means I’ll be sleeping in a hotel on a bed that countless others have laid on before me.  I generally try not to think about it.  I put on my blinders and blissfully believe that the freshly made bed actually has clean sheets on it and all will be well.  Unfortunately after reading a study by Oliveira et al in the April edition of AJIC titled “Recovery of resistant bacteria from mattresses of patients under contact precautions” my stomach started to turn, my mind has gone into imagination overdrive and I’m not sure I’m going to sleep like a baby tomorrow night…. 

It’s true, in healthcare facilities we know that mattresses are prone to contamination and are potential reservoirs for pathogens.  In fact I have written a couple of blogs in the past talking about the perils of mattresses.  “Mattresses – A Secret Storage Sinkhole” summarized an article that investigated a situation where after lying on a bed in a clean patient room a patient noticed that the back of the bed pad and mattress were contaminated with a blood-like fluid.  The pressure from the patient's weight on the bed caused the blood-like fluid to seep from the mattress and stain the bed pad and sheets. I said it then and I’ll say it now - #GROSS!!!!! 

An even earlier blog, Mattresses...a soft place on which to lounge, nap or sleep investigated cleaning practices and disinfectants used for cleaning and disinfecting mattresses.  The researchers found that while manufacturers who make the mattress material found on hospital beds recommend cleaning the mattress with soap and water, disinfecting the surface, and then rinsing, only 6 of the 113 hospitals they had spoken with were following these instructions.  The concern with not following the instructions is that the material will breakdown and lead to breaks in infection prevention.

In this most recent study, the researchers were able to find resistant bacteria from the majority of the mattresses they sampled, particularly from the lower region of the mattress.  About half of the resistant bacteria found on the mattresses were associated with the patient currently occupying the bed but the majority of the microorganisms could be associated to the previous bed occupant and NOT related to the current patient!  #YUCK!!

All this ties in to cleaning and disinfection and paying attention to what is probably the biggest fomite in the room!  Is it surprising that the lower region of the mattress was the most contaminated after cleaning?  Not to me!  Visualize the process of cleaning – you start at the top and work to the bottom.  The greatest amount of disinfectant is released at the top of the mattress and the cloth dries up as you get to the bottom.   There is sufficient science to support if you do not get sufficient disinfectant onto a surface for the contact time as noted on the disinfectant product you are using, you’re probably not going to kill the pathogens you need to!

I hope I haven’t ruined your weekend!  As for me – it has been shown that hotel mattresses are not cleaned between guests.  Can you imagine what I’d find if I were to test the mattress?  #IDONOTWANTTOKNOW!!

Bugging Off!


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