Abstract
This study aims to evaluate the potential role of pillboxes used for the preparation and delivery of individual daily medical treatments in the drug circuit of the Military Instruction Hospital (France) as reservoirs of bacterial contaminants. Samples were obtained from 32 pillboxes after decontamination (T1), after preparation in the pharmacy (T2), after use in two different medical units (T3), and again after usual mechanical washing (T4). Qualitative (identification and antibiotic susceptibility) and quantitative (contamination rate and number of colony forming units—CFUs) bacteriological tests were performed. Susceptible and resistant strains of environmental saprophytes were identified. The pillbox contamination rate was relatively low at T1 (13%). It was significantly increased at T2 (63%, p = 0.001 vs. T1), again at T3 (88%, p < 0.05 vs. T2, p < 0.001 vs. T1), and finally decreased dramatically at T4 (31%, p < 0.001 vs. T3, p > 0.05 vs. T1). The number of CFUs was significantly increased at T2 compared with that of T1 (36.7 ± 13.4 and 5.36 ± 3.64, respectively, p < 0.001) and again at T3 (84.4 ± 19.4, p < 0.001 vs. T1 and T2) and was significantly reduced at T4 (7.0 ± 2.0 vs. T3, p < 0.001) to a level that was not significantly different from that at T1. So, the use of pillboxes to deliver individual medications to patients in the hospital is a potential risk factor for bacterial cross-contamination.
Highlights
Infection prevention and control (IPC) is a universally relevant component of all health systems and affects the health and safety of both people who use health services and those who provide them [1].IPC is influenced by hospital hygiene and the expertise of the infection preventionists, pharmacists, and biologists for the prevention and management of the infection and infectious events [2].The transversal and interdisciplinary process called the drug circuit consists of the prescription, dispensing, administration and therapeutic follow-up stages and includes the processing of information [3,4]
We described four levels of potential contamination rates of pillboxes inside the drug circuit in two successive sets of experiments
The significance level was set at p < 0.05
Summary
Infection prevention and control (IPC) is a universally relevant component of all health systems and affects the health and safety of both people who use health services and those who provide them [1].IPC is influenced by hospital hygiene and the expertise of the infection preventionists, pharmacists, and biologists for the prevention and management of the infection and infectious events [2].The transversal and interdisciplinary process called the drug circuit consists of the prescription, dispensing, administration and therapeutic follow-up stages and includes the processing of information [3,4]. Infection prevention and control (IPC) is a universally relevant component of all health systems and affects the health and safety of both people who use health services and those who provide them [1]. IPC is influenced by hospital hygiene and the expertise of the infection preventionists, pharmacists, and biologists for the prevention and management of the infection and infectious events [2]. Additional precautions are needed for diseases transmitted by air, droplets and direct contact. These are termed “additional (transmission-based) precautions” and include the main hygiene standard such as hand hygiene, gown, gloves, surgical mask, goggles/face shield, and room placement, as well as the appropriate environmental measures [7]
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