Advertisement
PRACTICE FORUM| Volume 28, ISSUE 6, P465-471, December 2000

Download started.

Ok

Computer keyboards and faucet handles as reservoirs of nosocomial pathogens in the intensive care unit

      Abstract

      Purpose: We postulate that computer keyboards and faucet handles are significant reservoirs of nosocomial pathogens in the intensive care unit (ICU) setting. Methods: Sterile swab samples were obtained from 10 keyboards and 8 pairs of faucet handles in the medical ICU at Tripler Army Medical Center during a period of 2 months. Methicillin-resistant Staphylococcus aureus (MRSA) obtained from the environmental and patient specimens were sent for DNA identification by using pulsed-field gel electrophoresis. Results: A total of 144 samples were obtained (80 keyboards and 64 faucet handles), yielding 33 isolates. The colonization rate for keyboards was 24% for all rooms and 26% in occupied rooms. Rates for faucet handles in all rooms and occupied rooms were 11% and 15%, respectively. The environmental isolates annd their prevalence were: MRS, 49%; Enterococcus, 18%; Enterobacter, 12%; and all other gram-negative rods, 21%. Fourteen individual patient isolates were recorded: MRSA, 43%; Enterobacter, 21%; other gram-negative rods, 36%; and Enterococcus, 0%. By using pulsed-field gel electrophoresis, an indistinguishable strain of MRSA was identified in two patients, the keyboards and faucet handles in their respective rooms, and on other keyboards throughout the ICU, including the doctors’ station. Conclusions: The colonization rate for keyboards and faucet handles, novel and unrecognized fomites, is greater than that of other well-studied ICU surfaces in rooms with patients positive for MRSA. Our findings suggest an associated pattern of environmental contamination and patient infection, not limited to the patient’s room. Pulsed-field gel electrophoresis results have documented an indistinguishable strain of MRSA present as an environmental contaminant on these two fomites and in two patients with clinical infections patients during the same period. We believe these findings add evidence to support the hypothesis that these particular surfaces may serve as reservoirs of nosocomial pathogens and vectors for cross-transmission in the ICU setting. New infection control policies and engineering plans were initiated on the basis of our results. (AJIC Am J Infect Control 2000;28:465-70)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Smith MA
        • Mathewson JJ
        • Ulert IA
        • Scerpella EG
        • Ericsson CD.
        Contaminated stethoscopes revisited.
        Arch Intern Med. 1996; 156: 82-84
        • Boyce JM.
        Strategies for controlling methicillin-resistant Staphylococcus aureus in hospitals.
        J Chem. 1995; 7: 81-85
        • Barg NL.
        Environmental contamination with Staphylococcus aureus and outbreaks: the cause or the effect?.
        Infect Control Hosp Epidemiol. 1993; 14: 367-368
        • Tenover FC
        • Arbeit RD
        • Goering RV
        • Mickelson PA
        • Murray BE
        • Persing DH
        • et al.
        Interpreting chromosomal DNA restriction patterns produced by pulse-field gel electrophoresis: criteria for bacterial strain typing.
        J Clin Microbiol. 1995; 33: 2233-2239
        • Crosley K
        • Landesman B
        • Zaske D.
        An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides.
        J Infect Dis. 1979; 139: 280-287
        • Noskin GA
        • Stosor V
        • Cooper I
        • Peterson LR.
        Recovery of vancomycin-resistant enterococci on fingertips and environmental surfaces.
        Infect Control Hosp Epidemiol. 1995; 16: 577-581
        • Schaberg DR
        • Culver DH
        • Gaynes RP.
        Major trends in the microbial etiology of nosocomial infection.
        Am J Med. 1991; 91: 72S-75S
        • Thompson RL
        • Cabezudo I
        • Wenzel RP.
        Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus.
        Ann Intern Med. 1982; 97: 309-317
        • Boyce JM
        • Potter-Bynoe G
        • Chenevert C
        • King T.
        Environmental contamination due to methicillin-resistant Staphylococcus aureus: Possible infection control implications.
        Infect Control Hosp Epidemiol. 1997; 18: 622-627
        • Weber DJ
        • Rutala WA.
        Role of environmental contamination in the transmission of vancomycin-resistant enterococci.
        Infect Control Hosp Epidemiol. 1997; 18: 306-309
        • Haley RW.
        Methicillin-resistant Staphylococcus aureus: do we just have to live with it?.
        Ann Intern Med. 1991; 114: 162-164
        • Boyce JM.
        Methicillin-resistant Staphylococcus aureus detection, epidemiology, and control measures.
        Infect Dis Clin N Am. 1989; 3: 901-913
        • Getchell-White SI
        • Donowitz LG
        • Groschel DHM.
        The inanimate environment of an intensive care unit as a potential source of nosocomial bacteria: evidence for long survival of Acinetobacter calcoaceticus.
        Infect Control Hosp Epidemiol. 1989; 10: 402-407
        • Layton MC
        • Perez M
        • Heald P
        • Patterson JE.
        An outbreak of mupirocin-resistant Staphylococcus aureus on a dermatology ward associated with an environmental reservoir.
        Infect Control Hosp Epidemiol. 1993; 14: 369-375