Microbiological contamination of clipboards used for patient records in intensive care units

Abstract

Healthcare facility surfaces are recognized as reservoirs of epidemiologically relevant micro-organisms for healthcare-associated infections (HCAIs) [ [1] Ledwoch K. Dancer S.J. Otter A. Kerr K. Roposte D. Rushton L. et al. Beware Biofilm! Dry biofilms containing bacterial pathogens on multiple healthcare surfaces; a multicentre study. J Hosp Infect. 2018; 100: 47-56 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar ]. Micro-organisms, including multidrug-resistant (MDR) bacteria, can either contaminate surfaces as free-swimming planktonic bacteria or be incorporated into a dry surface biofilm (DSB), which consists of an aggregate of micro-organisms attached to a surface and immersed in extracellular polymeric substances, protecting them from antimicrobials and biocides [ [2] Hu H. Johani K. Gosbell I.B. Jacombs A.S. Almatroudi A. Whiteley G.S. et al. Intensive care unit environmental surfaces are contaminated by multiresistant bacteria in biofilms: combined results of conventional culture, pyrosequencing, scanning electron microscopy and confocal laser microscopy. J Hosp Infect. 2015; 91: 35-44 Abstract Full Text Full Text PDF PubMed Scopus (76) Google Scholar ]. Due to poor hand hygiene compliance, the surfaces mostly touched by healthcare workers (HCWs) have been shown to be the most heavily contaminated [ [3] Costa D.M. Johani K. Melo D.S. Lopes L.K.O. Lopes Lima L.K.O. Tipple A.F.V. et al. Biofilm contamination of high-touched surfaces in intensive care units: epidemiology and potential impacts. Lett Appl Microbiol. 2019; 68: 269-276 Crossref PubMed Scopus (18) Google Scholar ]. High-touch items include clipboards, which are used to hold patients' records. However, items such as patients' records are inadequately decontaminated as they are infrequently included in decontamination routines and/or allocation of cleaning responsibility is often lacking [ [4] Teng S.O. Lee W.S. Ou T.Y. Hsieh Y.C. Lee W.C. Lin Y.C. Bacterial contamination of patients’ medical charts in a surgical ward and the intensive care unit: impact on nosocomial infections. J Microbiol Immunol Infect. 2009; 42: 86-91 PubMed Google Scholar ].