Using a lotion glows under ultraviolet light, Canadian researchers have discovered that a third of patient toilets in hospitals are not cleaned properly.
Michelle Alfa, a researcher from Manitoba, says that spores from the nasty bacteria Clostridium difficile (C. difficile) linger in the loo even when it has been thoroughly wiped down.
She said that her finding is a result of a study published in BioMed Central's journal BMC Infectious Diseases, during which her team investigated the spread of so-called superbugs in hospitals.
Hospital patients are thought to catch bugs like vancomycin resistant Enterococci (VRE), methicillin resistant Staphylococcus aureus (MRSA) and C. difficile because they are not eradicated from the hospital environment.
These bugs may be transferred between patients through cross-contamination in the bathroom.
"Various studies have looked at the most effective cleaning agents, but none of these studies considered whether housekeeping staff were actually cleaning the toilets properly. It is impossible to assess the effectiveness of any action against these bacteria unless you can be sure that cleaners comply with protocols," says Alfa.
During the study, toilet inspectors smeared the UV lotion under the seats of 20 toilets and commodes, being used by patients with diarrhoea at a hospital in Winnipeg.
Seven patients had C. difficile infection, while 13 others did not.
The researchers tested the toilet seats and commodes every weekday for six months, and used UV light to determine how well they had been cleaned.
It was found that the commodes being used by the seven patients with C. difficle infections had not been properly cleaned 72 per cent of the time.
In addition, samples were taken from toilet surfaces to determine whether C difficile spores were present.
The toilets fared slightly better, with half of the samples taken showing no residual UV lotion after cleaning.
The 13 patients not on isolation had much cleaner toilets, with only 14 per cent glowing brightly under UV light.
It was also found that that differences in toilet cleaning were "ward dependent".
The researchers said that the results likely reflected characteristics of the individual cleaning staff because specific cleaners worked on different wards.
What makes the results even more worrisome is the fact that C. difficle was still detected in 40% of samples taken from the cleanest toilets, the ones with no detectable UV marker.
"This suggests that both the physical cleaning action as well as the disinfectant/cleaning agent were ineffective for killing and/or removing C. difficile from toilets," says Alfa.
"Our data suggest that without an agent with some activity against C. difficile spores the physical action of cleaning alone cannot be relied upon to effectively eradicate this organism from the toilets of patients who are shedding this type of spore. Nevertheless, we would still recommend that monitoring with a UV marker becomes a routine part of a hospital's housekeeping quality assurance programme," Alfa adds.