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)
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Article info
Footnotes
*The views expressed in this manuscript are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the United States government.
**Reprint requests: Dr Joel T. Fishbain, MCHK-DMI, Tripler Army Medical Center, Honolulu, HI 96859-5000.
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Copyright
© 2000 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
