Keyboard Contamination in Intensive Care Unit: Is Cleaning Enough? Prospective Research of In Situ Effectiveness of a Tea Tree Oil (KTEO) Film.

Gabriele Melegari,Ramona Iseppi,Alberto Barbieri,Valeria Caciagli,Enrico Giuliani,Patrizia Messi,Martina Mariani,Elisabetta Bertellini

doi:10.1007/5584_2020_575

Abstract

After the SARS-CoV-2 pandemic, disinfection practices and microbial load reduction have become even more important and rigorous. To determine the contamination of keyboard surface and the relative risk to transfer healthcare-associated pathogens to susceptible patients, as it frequently happens in Intensive Care Unit (ICU), a standard keyboard (SK), a cleanable keyless keyboard (KK) with smooth surface and a standard keyboard coated with a 3M Tegaderm® film added with active essential oil (tea tree oil) (KTEO) were tested. S. aureus, including MRSA strains, were detected in ICU, with values ranging from 15% to 57%. Gram negative strains belonging to the Enterobacteriaceae family were also found with values ranging from 14% to 71%. Similar Gram positive and Gram negative strains were found on all surfaces, but with low percentage, and only environmental bacteria were detected using the settling plates method. The Microbial Challenge Test performed on KTEO showed high rates of decrease for all the pathogens with statistical significance both at 24 and 48h (p=0.003* and p=0.040*, respectively). Our results suggest that the use of KTEO may be a feasible strategy for reducing the transmission of pathogens in health care setting and may be complementary to surface cleaning protocols.

Highlights

In the last years, multi-drug-resistant bacteria have risen to be among the most serious threat worldwide, especially when they are implicated in a great variety of environments linked to human’s health (Fernando et al 2017)
The aim of the study was to determine the contamination rate of 4 different keyboard systems four different keyboard systems, a standard keyboard (SK), a cleanable keyless keyboard (KK) with smooth surface, a laser keyboard (LK), and a standard keyboard coated with a 3 M Tegaderm® film added with active essential oil (KTEO), and to verify the survival of six healthcare-associated pathogens artificially inoculated on the least contaminated device
The keyboard added with the natural antibacterial compound (KTEO) device had a lower microbial load, with statistical difference compared to the SK and KK devices

Summary

Introduction

Multi-drug-resistant bacteria have risen to be among the most serious threat worldwide, especially when they are implicated in a great variety of environments linked to human’s health (Fernando et al 2017). Health professionals and work environments are often implicated, unintentionally, in the transmission of pathogens to patients and the workstation is one of the most important reservoirs of pathogenic bacteria. Effectiveness of cleaning and disinfection practices depends on many factors, including type of pathogen, its microbial load/organization in biofilm, sensitivity to biocides, concentration and time of contact of chemical agent, and last but not least, staff compliance (Almatroudi et al 2018; Assere et al 2008; El-Azizi et al 2016). These aspects are often not enough to guarantee hospitalized patients a significant risk reduction of acquiring an infection. All chemical and physical changes to surfaces capable of reducing microbial contamination are important prevention tools (Adlhart et al 2018)

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