Blood pressure cuffs as a potential fomite for transmission of pathogenic micro- organisms: A prospective study in a university teaching hospital

Abstract

Objective: To investigate the contamination of blood pressure cuffs on medical, surgical, paediatric and intensive care areas in a university teaching hospital. Design: A comprehensive, prospective study quantitatively and qualitatively evaluating the bacterial contamination on blood pressure cuffs of 100 sphygmomanometers in use in ten hospital units from June through to July 2007. Setting: A university teaching hospital with medical, surgical, paediatric and intensive care units. Results: The inner sides of the cuffs were found to harbour more organisms (97%) compared to the outer surface (89%). The inside also had a much higher level of contamination, 29% having >100 colony forming units (cfu) compared to only 8% with >100cfu on the outer surface. On average most cuffs were found to have organisms in the 10—100 cfu range. The most heavily contaminated cuffs (>100cfu) were found on the general intensive care unit. Coagulase negative Staphylococcus was the most commonly isolated organism, found in 67% of samples.

The Potential for Transmission of Hospital-Acquired Infections by Non-critical Medical Devices: The Role of Thermometers and Blood Pressure Cuffs

“…Briefly, with the aid of sterile gloves, an estimated surface area of 100 cm 2 of BP cuff material coming into direct contact with patients' skin during BP measurement was swabbed using a sterile swab stick moistened with physiological saline. Likewise, thermometers were swabbed using swab sticks moistened with physiological saline as described by Baruah et al (2008). Swabs were labelled appropriately and transferred to the Medical Microbiology Laboratory of Ebonyi State University Abakaliki for analysis.…”

“…Most attention to HAI prevention is given to high-risk invasive diagnostic and therapeutic healthcare tools, while the importance of less critical tools tends to be underestimated (Schwegman 2008;Uneke and Ijeoma 2010). Recent studies have reported the potential nosocomial spread of microbial flora by means of non-critical healthcare tools including stethoscopes (Uneke et al 2009;Schroeder et al 2009), ultrasound transducers (Schabrun et al 2006), gloves (Katherason et al 2010), tourniquets (Ormerod et al 2006), physicians' and nurses' pens (Wolfe et al 2009), scissors (Cleal 2006), white coats (Treakle et al 2009; Uneke and Ijeoma 2010), thermometers (Donkers et al 2001) and blood pressure (BP) cuffs (Baruah et al 2008;Davis 2009).…”

“…Thermometers and BP (sphygmomanometer) cuffs are among the most commonly used non-critical medical devices in hospital settings. Both have been associated with the spread of HAI in healthcare facilities (Baruah et al 2008;Davis 2009). Thermometers in particular are linked to the outbreak of nosocomial infections in critical hospital units such as the intensive care unit (ICU) and neonatal and burns units (Donkers et al 2001;Martínez-Pellús et al 2002;v Dijk et al 2002).…”

“…In an earlier report, Livornese et al (1993) found that an electronic thermometer was the vehicle that caused an outbreak of vancomycin-resistant Enterococcus faecium in a medical/ surgical intensive care unit and ward of a university hospital. Similarly, a number of investigations including very recent studies have identified BP cuffs as potential vehicles for transmission of nosocomial infection in selected patient populations (Baruah et al 2008;Base-Smith 1996;Davis 2009;Walker et al 2006). BP cuffs have been associated with outbreaks of mupirocin-resistant Staphylococcus aureus, methicillin-resistant S. aureus (MRSA) and borderline methicillin-susceptible S. aureus (BMSSA) in various hospital settings (Boyce et al 1997;Layton et al1993;Webb 2002).…”

Unsafe health and safety: sphygmomanometer cuffs are not interchangeable

“…The decision to change cuffs arose from a concern about potential transmission of infection between patients while having their BP measured. 3 Documented evidence in the literature, to support or refute the interchanging of cuffs between devices, is lacking, although current CE marking regulations require that BP devices (including cuffs) are formally validated according to recognised protocols. A new UM-101 was purchased and a systematic comparison of the manufacturer-supplied versus replacement cuffs undertaken and the results of this comparison are presented here.…”