Cleaned, Ready-to-Use, Reusable Electrocardiographic Lead Wires as a Source of Pathogenic Microorganisms

Abstract

Background Cleaned electrocardiographic lead wires are a potential source of microorganisms capable of causing nosocomial infection. Objectives To examine fungal and bacterial growth on cleaned reusable lead wires, determine if microbial growth is associated with hospital site or work environment, determine the prevalence of antibiotic-resistant bacteria, and learn if antibioticresistant bacteria are associated with hospital site and work environment. Methods Cleaned lead wires (N = 320) from critical care and telemetry units, emergency departments, and operating rooms of 4 hospitals were swabbed and the specimens cultured for microbial growth. Bacterial species were grouped by their risk for human infection: at risk (n = 9), potential risk (n = 5), and no risk (n = 10). Work environments were compared by using pairwise contrasts from a generalized estimating equation model. Results Fungi were rare (0.6%). Of 226 cultures from 201 wires (62.8%) with bacterial growth, 121 were of at-or potential-risk bacteria (37.8%). Urban hospitals had less growth (P ≤ .001) and fewer bacterial species per wire (P ≤ .001) than did community hospitals. Presence of any bacteria (P = .02) and number of bacterial species per wire (P = .002) were lowest in operating rooms; emergency departments and telemetry units had more growth than did critical care units. Among specimens of staphylococci and enterococci, 6 each were sensitive to antibiotics; of 4 resistant staphylococcal species, 1 was not a human opportunistic pathogen and 3 were potential-risk species.

Infection Rates in Intensive Care Units by Electrocardiographic Lead Wire Type: Disposable vs Reusable

“…Previously, ultrasound cleaning of ECG-LWs was hypothesized to be the reason why fewer bacteria grew on ECG-LWs in ICUs. 12 In this study, both the disposable and reusable cardiovascular surgery ICU ECG-LW groups had fewer HAIs than patients in other ICU environments; however, no between-group differences in the rate of HAIs were found. Thus, ultrasound cleaning of reusable ECG-LWs did not offer benefit over the cleaning practices used in the other adult ICUs and did not provide an explanation for the lower incidence of HAIs among the cardiovascular ICUs.…”

“…Despite infection control practices surrounding cleaning techniques by hospital personnel, bacteria can remain latent on inanimate surfaces such as door knobs, identification badges, stethoscopes, bath basins, sharps containers, tourniquets, [5][6][7][8][9][10][11] and electrocardiographic lead wires (ECG-LWs), 13,14 and may be a source of crosscontamination and nosocomial infection, especially in patients who are immunocompromised. 12,13 Although it is known that ECG-LWs are a reservoir source for microorganisms, it is unknown if disposable ECG-LWs would lead to a decrease in infection rates compared with cleaned, reusable ECG-LWs. Disposable ECG-LWs do not require adherence to optimal cleaning procedures because they are discarded after one use.…”

Cleanliness of Disposable vs Nondisposable Electrocardiography Lead Wires in Children

“…Whether or not the contaminants were harmful is unknown. [5][6][7] However, the researchers did discover higher ATP counts on the nondisposable ECG leads than the disposable ones. This finding is important in light of the work by Barnett 4 and Brown.…”

“…The potential for cross-contamination from an unclean ECG lead wire to the surgical site is of great concern. 3,4 In one report, 5 37.8% of reusable ECG leads swabbed in ready-touse rooms and storage areas were colonized with atrisk or potential-risk bacteria. In another study, 6 researchers sampled more than 400 cleaned and disinfected ECG lead wires throughout 4 intensive care units and 1 postanesthesia care unit.…”

A wireless system for gastric slow wave acquisition and gastric electrical stimulation

“…However, existing serosal and mucosal recording systems transmit signals via lead wires traversing the abdominal wall or natural orifice. These wires are a conduit for infection, induce discomfort, become displaced, and restrict mobility when connected to bulky acquisition systems [3]; hence, the monitoring period is limited to the anaesthetized state. We advocate wireless technology to overcome these barriers.…”