Evaluation of the potential for electronic thermometers to contribute to spread of healthcare-associated pathogens

John, Amrita; Alhmidi, Heba; Cadnum, Jennifer L.; Jencson, Annette; Gestrich, Scott; Donskey, Curtis J.

doi:10.1016/j.ajic.2017.12.005

Cited by 10 publications

(9 citation statements)

References 10 publications

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“…The Working Party considered the above evidence and the recommendations from previous guidelines and concluded that evidence suggests that patient transfers contribute to transmission of MRSA. There was weak evidence of potential risk of MRSA transmission from eight studies [239][240][241][242][243][244][245][246] which evaluated microbial contamination of shared equipment. One experiment 239 with MRSA, and that after using the UV device, the number reduced to four (9%) (p<0.01).…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

Coia

Wilson

Bak

et al. 2021

Journal of Hospital Infection

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Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

Coia

Wilson

Bak

et al. 2021

Journal of Hospital Infection

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“…Benign surrogate markers can provide a powerful tool in investigations of mechanisms of transmission. [10][11][12][13][14][15] In the current study, benign cauliflower mosaic virus DNA markers were frequently transferred from an inoculated source patient and from surfaces in the source patient's room to subsequent patients during routine clinical interactions. Based on observations of interactions and sites of DNA recovery, the hands of personnel were the most common source of DNA transfer, but stethoscopes, clothing of personnel, and blood pressure cuffs were also implicated as frequent sources of transfer of the DNA markers.…”

Section: Discussionmentioning

confidence: 98%

“…In several recent studies, cauliflower mosaic virus DNA markers have been used to as benign surrogate markers to study routes of pathogen transmission. [10][11][12][13][14] For example, in a medical and surgical intensive care unit, it was demonstrated that a viral DNA marker inoculated onto shared portable equipment disseminated widely to surfaces in patient rooms and provider work areas and to other types of portable equipment. 11 The viral DNA marker is like C. difficile spores in that it is not affected by alcohol hand sanitizer or quaternary ammonium disinfectants but is denatured by sodium hypochlorite and reduced by mechanical washing or wiping.…”

mentioning

confidence: 99%

Use of viral DNA surrogate markers to study routes of transmission of healthcare-associated pathogens

Thakur

Alhmidi

Cadnum

et al. 2020

Infect. Control Hosp. Epidemiol.

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Background: The hands of healthcare personnel are the most important source for transmission of healthcare-associated pathogens. The role of contaminated fomites such as portable equipment, stethoscopes, and clothing of personnel in pathogen transmission is unclear. Objective: To study routes of transmission of cauliflower mosaic virus DNA markers from 31 source patients and from environmental surfaces in their rooms. Design: A 3-month observational cohort study. Setting: A Veterans’ Affairs hospital. Methods: After providing care for source patients, healthcare personnel were observed during interactions with subsequent patients. Putative routes of transmission were identified based on recovery of DNA markers from sites of contact with the patient or environment. To assess plausibility of fomite-mediated transmission, we assessed the frequency of transfer of methicillin-resistant Staphylococcus aureus (MRSA) from the skin of 25 colonized patients via gloved hands versus fomites. Results: Of 145 interactions involving contact with patients and/or the environment, 41 (28.3%) resulted in transfer of 1 or both DNA markers to the patient and/or the environment. The DNA marker applied to patients’ skin and clothing was transferred most frequently by stethoscopes, hands, and portable equipment, whereas the marker applied to environmental surfaces was transferred only by hands and clothing. The percentages of MRSA transfer from the skin of colonized patients via gloved hands, stethoscope diaphragms, and clothing were 52%, 40%, and 48%, respectively. Conclusions: Fomites such as stethoscopes, clothing, and portable equipment may be underappreciated sources of pathogen transmission. Simple interventions such as decontamination of fomites between patients could reduce the risk for transmission.

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“…1,2 Contaminated shared electronic thermometers and temperature probes have been linked to transmission of C. difficile, VRE, and the emerging fungal pathogen Candida auris. [6][7][8] Finally, some recent studies have suggested that floors might be an underappreciated source of pathogen transmission. [9][10][11][12][13] For example, a nonpathogenic virus inoculated onto floors in patient rooms disseminated rapidly to the hands of patients and to surfaces in the room.…”

mentioning

confidence: 99%

Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

Redmond

Pearlmutter

Ng-Wong

et al. 2021

Infect. Control Hosp. Epidemiol.

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Objective: To investigate the timing and routes of contamination of the rooms of patients newly admitted to the hospital. Design: Observational cohort study and simulations of pathogen transfer. Setting: A Veterans’ Affairs hospital. Participants: Patients newly admitted to the hospital with no known carriage of healthcare-associated pathogens. Methods: Interactions between the participants and personnel or portable equipment were observed, and cultures of high-touch surfaces, floors, bedding, and patients’ socks and skin were collected for up to 4 days. Cultures were processed for Clostridioides difﬁcile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Simulations were conducted with bacteriophage MS2 to assess plausibility of transfer from contaminated floors to high-touch surfaces and to assess the effectiveness of wearing slippers in reducing transfer. Results: Environmental cultures became positive for at least 1 pathogen in 10 (59%) of the 17 rooms, with cultures positive for MRSA, C. difficile, and VRE in the rooms of 10 (59%), 2 (12%), and 2 (12%) participants, respectively. For all 14 instances of pathogen detection, the initial site of recovery was the floor followed in a subset of patients by detection on sock bottoms, bedding, and high-touch surfaces. In simulations, wearing slippers over hospital socks dramatically reduced transfer of bacteriophage MS2 from the floor to hands and to high-touch surfaces. Conclusions: Floors may be an underappreciated source of pathogen dissemination in healthcare facilities. Simple interventions such as having patients wear slippers could potentially reduce the risk for transfer of pathogens from floors to hands and high-touch surfaces.

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Evaluation of the potential for electronic thermometers to contribute to spread of healthcare-associated pathogens

Cited by 10 publications

References 10 publications

Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

Use of viral DNA surrogate markers to study routes of transmission of healthcare-associated pathogens

Timing and route of contamination of hospitalized patient rooms with healthcare-associated pathogens

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