Study finds training and audit can cut clinic contamination: full analysis

A new study in the Journal of Small Animal Practice suggests many veterinary practices may be able to cut environmental contamination substantially with a straightforward package: staff training, better sanitisation protocols, and regular measurement of hygiene performance. According to the paper by N. A. Forbes, contamination levels in 13 small animal practices dropped markedly after a brief educational intervention and repeated unannounced ATP-based surface testing. (pubmed.ncbi.nlm.nih.gov)

The backdrop is familiar to anyone working in small animal medicine. Infection prevention and control has become more urgent as practices manage more complex patients, more intensive care, and ongoing antimicrobial resistance concerns. Published reviews have noted that the veterinary hospital environment can act as a reservoir for hospital-associated infections, while recent expert commentary has argued that environmental microbiological surveillance should play a larger role in veterinary infection control programs. (pmc.ncbi.nlm.nih.gov)

In Forbes’ study, the goal was to quantify surface contamination in real-world practice and test whether it could be reduced through training, good sanitisation, and regular monitoring. Before the intervention, contamination levels averaged 23.3 times the recommended maximum, with a 92% failure rate across sampled areas. The thresholds cited were stricter in higher-risk spaces, ranging from 100 in public and clerical areas to 10 in food preparation and sterile areas. After a 45-minute training session and adoption of a two-stage protocol, average contamination dropped to 6.9 times the recommended maximum at the first follow-up, an average reduction of 66.1%. At the second follow-up, the reduction from baseline reached 83.6%, with contamination falling to 3.3 times the maximum recommended level. (pubmed.ncbi.nlm.nih.gov)

Industry reaction has focused on how operational the recommendations are. BSAVA and Improve International both highlighted the study’s call for practices to appoint an Infection Control Champion, use routine ATP testing, ideally monthly, and reinforce team-wide understanding of infection sources, transmission routes, and risk management. That framing matters because it turns infection control from a one-off cleaning initiative into a repeatable audit-and-feedback system. (bsava.com)

The findings also fit with a broader evidence base showing that education can improve infection prevention behaviors, though not always completely. In a 2023 Swiss study of four companion animal clinics, IPC scores improved from a median 57.8% to 82.9% one month after intervention, and hand hygiene compliance roughly doubled, from 20.9% to 42.5%. But one clinic still had extensive contamination with antimicrobial-resistant organisms, including carbapenemase-producing Enterobacterales, before and after the intervention. That’s a useful reminder that education and cleaning protocols can move the needle, but they may not fully solve entrenched contamination problems without deeper systems changes. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For veterinary teams, this study supports a practical message: what gets measured gets managed. Surface hygiene is often assumed rather than verified, and this paper suggests that unannounced environmental testing can expose gaps that standard routines miss. That has implications not only for patient safety, but also for staff health, zoonotic risk, antimicrobial stewardship, and trust with pet parents. Prior literature has linked veterinary environments and devices to contamination with enteric and environmental pathogens, and infection control guidance consistently emphasizes cleaning, disinfection, hand hygiene, staff education, and surveillance as core program elements. (pmc.ncbi.nlm.nih.gov)

There are still limits to keep in mind. The published abstract emphasizes contamination reduction, not direct measurement of downstream clinical outcomes such as lower nosocomial infection rates. ATP testing is also a proxy for cleanliness rather than a direct measure of specific pathogens. Even so, the study gives practices something many infection control discussions lack: a measurable, clinic-level framework that appears feasible to implement without major capital investment. That may be especially relevant for independent and mid-sized practices trying to strengthen infection prevention with limited time and staffing. (pubmed.ncbi.nlm.nih.gov)

What to watch: Expect interest in whether ATP surveillance becomes more common in first-opinion and referral settings, whether veterinary groups formalize Infection Control Champion roles, and whether follow-up research can connect environmental audit gains to harder endpoints such as fewer hospital-associated infections, lower antimicrobial-resistant organism burden, and better compliance over time. (bsava.com)