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Portable ICU equipment is a potential vector for spreading pathogens
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Shared hospital equipment is a potential vector for pathogens in an ICU setting, according to findings published in Infection Control and Hospital Epidemiology.
“Effective disinfection of contaminated surfaces is needed to prevent transmission of health-care associated pathogens,” Curtis J. Donskey, MD, of the Geriatric Research, Education and Clinical Center at Cleveland Veterans Affairs Medical Center, and colleagues wrote.
Clinical guidelines recommend that health care staff should disinfect shared portable equipment, such as wheelchairs and vital signs equipment, the researchers wrote.
“However, in busy health care settings, cleaning of shared medical equipment may be suboptimal.”
The researchers used the cauliflower mosaic virus to generate a 222-base-pair DNA marker, and applied the marker to various pieces of equipment in the ICU of a 215-bed acute-care VA hospital. Donskey and colleagues placed the marker on 13 ultrasound machines in a surgical ICU and electrocardiogram machines in a medical ICU, placing an additional fluorescent marker on each item to assess cleaning practices. Neither hospital staff nor patients were made aware of the study. The researchers then swabbed high-touch surfaces in patient rooms and work areas at and days after application of the DNA marker.
Donskey and colleagues reported finding the DNA marker at a similar percentage of sites in each ICU: 14% (n = 14 of 100) in the surgical ICU and 9% (n = 11 of 128) the medical ICU. On the first two days after application of the marker, none of the devices in the study showed evidence of having been cleaned, the researchers wrote. However, on day 6, some equipment appeared to have been cleaned: the fluorescent marker appeared on the ultrasound machines but not the electrocardiogram machines. Furthermore, Donskey and colleagues did not detect any marker DNA in the medical ICU on day 6. All control swabs were negative, the researchers reported.
“In summary, our findings suggest that shared portable equipment might be an underappreciated vector for pathogen transmission in health care settings,” Donskey and colleagues wrote. “Effective use of personal protective equipment, hand hygiene and environmental disinfection may be useful to reduce the risk of would be dependent on compliance of health care staff. Further research is needed to evaluate alternate methods of disinfection of portable equipment that would allow for adequate disinfection without interfering with workflow.” – by Andy Polhamus
Disclosure: Donskey reports grants from EcoLab, Gojo, Merck and Steris, as well as an advisory role with 3M. No other researchers report any relevant financial disclosures.
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