Potential Source Of Cross-infection Research Articles

Antibiotic Resistant Staphylococcus spp Isolates Colonizing Some College Students Laboratory Coats

Aim: Laboratory coats may act as fomites for the continued dissemination of antibiotic resistant bacteria. This study aimed at detecting the level and type of antibiotic resistant microorganisms’ on laboratory coats of students of Dora Akunyili College of Pharmacy, Igbinedion University Okada, Edo State. Nigeria.
 Place and Duration of Study: Dora Akunyili College of Pharmacy, Igbinedion University Okada, Edo State. Nigeria between September and October, 2020.
 Methodology: A total of 20 pharmacy students working in various laboratories in the college were included in the study to evaluate the bacterial contamination of laboratory coats. Swabs were obtained from 3 different areas of the laboratory coat – collar, pocket, and wrist and processed in the Pharmaceutical Microbiology laboratory based on standard microbiological techniques. Antibiotic susceptibility testing was carried out on the isolates obtained by Kirby-Bauer method for 10 antibiotics.
 Results: This study revealed that 83% of the coats were contaminated with Staphylococcus spp. White coats of male subjects were more contaminated than that of the female subjects and the pockets were sites which had the highest percentage of finding bacteria. Antibiotic sensitivity testing showed isolates on the laboratory coats resistant to cloxacillin, erythromycin, ceftriaxone, cefuroxime, ceftazidime, augmentin and oxacillin.
 Conclusion: The detection of antibiotic resistant isolates of Staphylococcus spp from the laboratory coats of pharmacy college students suggests that the clothing may harbor pathogenic organisms. This study also highlights the importance of laboratory coats as potential source of cross infection.

The Way of Laryngoscope Disinfection: A Survey of Practice in Various Hospitals and Clinics

Background and Aims: During general anaesthesia, laryngoscope is a common equipment for intubation used by anaesthesiologists. Laryngoscope has been identified as a potential source of cross infection. Though guidelines exist for appropriate disinfection practices, recent reviews suggested that current methods of disinfection areless effective and compliance is poor with the established protocols. We conducted a questionnaire-based survey to study the current disinfection practices being followed by a cross section of anaesthesiologists.
 Methods: A simple questionnaire containing 14 questions was distributed amongst anaesthesiologists through online as well as direct contact. Data were analyzed with percentage analysis.
 Results: Out of 150 anaesthesiologists, 120 submitted the completed questionnaires. Residents constituted 41% and 46% were consultants. Eighteen (12%) used only tap water for cleaning and 132 (88%) used a chemical agent after rinsing with water. Out of 132, 76 (51%) used detergent/soap solution, 29 (19%) would wash and then soak in disinfectant or germicidal agents (glutaraldehyde, povidone iodine and chlorhexidine) and 18 (12%) would wipe the blade with an alcohol swab. With respect to disinfection of laryngoscope handles, 70% respondents said they used an alcohol swab, 18% did not use any method, 9% were not aware of the method being used, while 3% did not respond.
 Conclusion: Our results indicate wide variation in methods of decontamination of laryngoscopes. Awareness regarding laryngoscope as a potential source of infection was high. We need to standardize and implement guidelines on a national level and make available resources which will help to improve patient safety.
 CBMJ 2020 January: Vol. 09 No. 01 P: 04-10

Reprocessing effectiveness of gastrointestinal endoscopes in western Algeria hospitals: Infectious risk and biofilm formation

The significant increase in endoscopic procedures can lead to a potential source of cross-infection accompanied by biofilm formation on the devices when the disinfection procedure is unsuitable. This study, the first in Algeria, aims to describe the microbiological quality of gastroscopes used in gastroin-testinal units of western Algeria hospitals and to implement some corrective measures. A total of 132samples from endoscopes were examined over a period of 2 years. Contamination level of samples was evaluated by CFU count. Identification of the isolates was made by MALDI Biotyper System. Biofilm formation was detected by Congo Red Agar and tissue Culture Plate method (TCP). The endoscope-drying effectiveness was analyzed by bacterial count and Scanning Electron Microscopy (SEM). Microbial growth was de-tected in 68.18%of endoscopes; 150strains were isolated: Gram-negative-bacilli (56%), Gram-positive-cocci (26.66%), Gram-positive-bacilli(17.33%); dominant species were Enterobacter cloacae, coagulase-negative Staphylo-cocci, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus. Forty one out of 132 samples collected after disinfection disclosed Enterobacteriaceae (41.93%), Pseudomonaceae (16.12%), Staphylococci (30.64%) and Bacillus (11.29%). Using TCP, 96 isolates were good biofilm-producers. The drying reduced significantly the rate of CFU growth for all channels with absence of indicators bacteria. Drying had a better inhibition on biofilm formation, SEM observation revealed a very low abundance of biofilms. Our study is the first in Algeria to describe microbiological findings of post-reprocessing-gastroscopes. Biofilms inside endoscope result in de-contamination failure. Rigorous cleaning/disinfection and drying with com-pressed air are essential elements that reduce the contamination level and biofilm formation inside endoscopes.

Disinfection of laryngoscopes: A survey of practice.

Background and Aims:The laryngoscope is a common piece of equipment used by anaesthesiologists. It has been identified as a potential source of cross infection. Although guidelines exist regarding appropriate disinfection practices, recent reviews suggest ineffectiveness of current methods of disinfection and poor compliance with the established protocols. We conducted a questionnaire-based survey to study the current disinfection practices being followed by a cross section of anaesthesiologists.Methods:A simple questionnaire containing 13 questions was distributed amongst anaesthesiologists in an anaesthesia conference. Data were analysed with percentage analysis.Results:Out of 250 delegates who attended the conference, 150 submitted the completed questionnaires. Residents constituted 41% and 46% were consultants. Eighteen (12%) used only tap water for cleaning and 132 (88%) used a chemical agent after rinsing with water. Out of 132, 76 (51%) used detergent/soap solution, 29 (19%) would wash and then soak in disinfectant or germicidal agents (glutaraldehyde, povidone iodine and chlorhexidine) and 18 (12%) would wipe the blade with an alcohol swab. With respect to disinfection of laryngoscope handles, 70% respondents said they used an alcohol swab, 18% did not use any method, 9% were not aware of the method being used, while 3% did not respond.Conclusion:Our results indicate wide variation in methods of decontamination of laryngoscopes. Awareness regarding laryngoscope as a potential source of infection was high. We need to standardise and implement guidelines on a national level and make available resources which will help to improve patient safety.

Comparison of efficacy and cost-effectiveness of 0.55% ortho-phthalaldehyde and 2% glutaraldehyde for disinfection of laryngoscopes: A prospective pilot study.

Background and Aims:The laryngoscope is a potential source of cross-infection as it involves contact with the mucous membrane, saliva and occasionally blood. This study compared efficacy and cost-effectiveness of two Centre for Disease Control approved agents for disinfection of laryngoscope blades.Methods:One hundred and sixty patients requiring laryngoscopy and intubation for general anaesthesia were randomly allocated into two groups. After tracheal intubation, used laryngoscope blades were cleaned with tap water. The blades were then immersed in either 2% w/v glutaraldehyde for a contact time of 20 min or 0.55% w/v ortho-phthalaldehyde (OPA) for 10 min. The handles were wiped with 0.5% w/v chlorhexidine wipes. Samples were collected using sterile cotton swabs from the tip, flange and light bulb area of the laryngoscope blade and one from the handle. They were cultured aerobically on blood and McConkey agar.Results:In 2% glutaraldehyde group, of 240 samples sent from the blades, 2 (0.8%) showed the growth of methicillin-resistant coagulase-negative staphylococci (MRCONS) and Enterobacter. In OPA group, of 240 samples, 2 (0.8%) showed growth of MRCONS. Thus, 2% glutaraldehyde and 0.55% OPA were comparable in terms of efficacy of disinfection. Growth was seen on 4 out of 160 handles.Conclusions:We suggest OPA for high-level disinfection of laryngoscope blades as it is equally efficacious as compared to glutaraldehyde, with a shorter contact time and available as a ready to use formulation.

Microbial flora on the white coats of dental health care professionals

Objective: To determine the types of microbial flora present on the white coats of dental healthcare professionals in a Dental Institution and Hospital. Materials and Methods: A total of 100 white coats of dental healthcare professionals were included in the study. An informed consent and questionnaire were taken. A cross-sectional survey was designed with bacterial contamination of white coats in three predetermined areas (chest, pocket, and sleeves). Sterile swabs were moistened with sterile saline. The growth on the plates was determined based on colony morphology, gram-staining, and standard biochemical tests. Chi-square test was used to assess the association among the study variables. Results: Of the total sample, five washed their white coats every day, 60 weekly once, and 35 weekly twice. About 12% of the doctors exchanged their white coats. About 33% of the doctors wore their white coats while eating. Staphylococcus aureus was the most predominant isolate found on the sleeves, and Escherichia coli was found on the pockets. Most of the organisms were seen Gram-positive staphylococci and Gram-negative E. coli. No statistically significant association between the overall presence of microbial flora was observed when compared with different gender, frequency of washings, and practice of exchanging. Conclusions: White coats are a potential source of cross-infection even in dental settings and surroundings. It is therefore recommended that guidelines be prepared for handling and cleaning procedures of white coats.

Bacterial contamination in a special care baby unit of a tertiary hospital in Jos, Nigeria

Nosocomial infections pose a great challenge on healthcare systems. Although surfaces in neonatal wards, umbilical stump wounds and catheter are responsible for a high number of nosocomial infections due to bacteria. The aim of this study was to determine the bacterial profile of air and surface contamination in the special care baby unit of a tertiary hospital in Jos, Nigeria.Surface and air samples were cultured and antibiotic susceptibility of isolated bacteria were determined.The bacterial profile of air and surface samples showed that Klebsiella was the most common bacteria followed by Staphyllococcus; while the least was Escherichia. Most of the bacteria were isolated from the out-born term area of the special care baby unit. All the bacteria isolated were susceptible to ceftriaxone and meropenem.This study showed that all areas of the special care baby unit of the hospital have bacterial, indicating that these are a potential source of cross-infection from healthcare workers to the neonatal patients.

Bacterial Contamination of Medical Doctors and Students White Coats at Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Background. Microbial transmission from patient to patient has been linked to transient colonization of health care workers attires. Contamination of health care workers' clothing including white coats may play a big role in transmission of microbes. Study Objective. This study was conducted to determine the type of bacterial contamination on the white coats of medical doctors and students and associated factors. Methods. A cross-sectional study with purposive sampling of the bacterial contamination of white coats was undertaken. Demographic variables and white coats usage details were captured: when the coat was last washed, frequency of washing, washing agents used, and storage of the white coats. Swabs were collected from the mouth of left and right lower pockets, sleeves, and lapels of white coat in sterile techniques. Results. Out of 180 participants involved in the current study, 65.6% were males. Most of the coats were contaminated by staphylococci species and other bacteria such as Gram negative rods. Conclusion and Recommendations. White coats are potential source of cross infection which harbour bacterial agents and may play a big role in the transmission of nosocomial infection in health care settings. Effort should be made to discourage usage of white coats outside clinical areas.

White coats: how much safe are they?

Background: Various studies have suggested that health care workers'(HCW) clothing, including white coats, are potential reservoirs for microorganisms causing health care associated infections, reinfecting the hands of HCWs and may be a vector for transmission of nosocomial pathogens. Hence the present study was undertaken to detect the incidence of pathogenic microorganisms that contaminate nurses white coats. Methods: Total 324 swabs, collected by swabbing the three sites of the surface of the Nurses’ white coat (pockets, abdominal zone and the sleeve ends) were inoculated on blood agar, Mac-Conkey’s agar and incubated at 37°C overnight. Microbial growth was identified by standard methods. Antibiotic sensitivity test was carried out by Kirby-Baur disc diffusion method as per CLSI guidelines. Results: Non-pathogenic bacteria (skin flora) were isolated from all white coat culture and pathogenic bacteria from 76 (70.3%) white coats (45 from Surgery & allied departments, 31 from Medicine & allied departments). From total 324 samples, 85 (26.2%) samples were positive for pathogenic bacteria and total 94 pathogenic bacteria were isolated which includes 33 (35.1%) Staphylococcus aureus (6 MRSA, 27 MSSA), 56 gram negative bacilli (17 ESBL producers). The rate of contamination with pathogens, was higher on pockets (57.4%) compared with abdominal zone (27.6%) and sleeve ends (14.8%). Conclusions: The study highlights the importance of white coats as potential source of cross infection. A strict protocol should be followed for preventing cross-contamination from the white coats.

Microbial diversity in dental unit waterlines.

Dental health care providers and patients are exposed during ongoing work to contamination by the water used in the dental units, due to accidental swallowing or aspiration of the sprays generated by the high-speed handpiece and the threeway syringe. This study evaluated the quality of water in dental units in the public dental care system of Maceio, Alagoas, Brazil, by conducting analyses of contamination by total coliforms, E.Coli, heterotrophic bacteria and filamentous fungi. We collected 200 mL of water at 5 sites in 6 dental offices of the Department of Health located in different parts of the city. A total 212 isolates and 16 genera of filamentous fungi were identified in the water collected from the dental units. Total coliforms indicated that the water used in dental units was not appropriate for human consumption. The high levels of contamination found in this study showed that water was a potential source of cross-infection.

Microbial Flora on Aprons of Dental Healthcare Professionals

Objective : To determine the microbial flora present on aprons of dental healthcare professionals in a dental college & hospital. Materials and methods: Total 100 aprons of dental healthcare professionals were included in the study. An informed consent and questionnaire was taken. A cross sectional survey was designed with bacterial contamination of aprons in three predetermined areas (chest, pocket, sleeves). Result: It was observed that 66% of dental healthcare professionals used to wash their aprons once in a week with self grading by the participants, 92% of aprons were moderately clean. 71% of dental health care professionals used to wear their aprons while eating and at nonclinical areas. 88% of chest,84% of pocket and 71% of sleeves of aprons showed growth of microorganisms. Staphylococcus aureus was the most predominant isolate followed by Bacillus species and other all isolates were either environmental microorganisms or skin commensals. Methicillin Resistant Staphylococcus aureus (MRSA) was also found, which was a matter of concern. Conclusions: Aprons are a potential source of cross infection even in dental settings. It is recommended that guidelines should be there for handling and washing procedures of aprons.

Fungal and Bacterial Contamination on Indoor Surfaces of a Hospital in Mexico

: Background: Nosocomial infections acquired during hospitalization depend on the characteristics of the microorganisms, with a high risk of these being acquired when the environment is contaminated. Cross-transmission of microorganisms by contaminated surfaces and the hands of health care workers are considered to be the main route of the spread of nosocomial infections and in many Mexican hospitals, information about microbial and fungi contaminants on indoor surfaces is insufficient.Objectives: In this study, we explore the bacterial and fungal genera present on surfaces taken from; armrest beds, wash sinks, medical tables, and the hands of medical staff from emergency, intensive care unit, inhalation therapy, stomatology and pediatric areas.Materials and Methods: The present study was conducted in a hospital located in Xalapa City in Mexico; the samples were taken during a 6 month period from August to December, 2010. Surface swab specimens were collected from predefined surfaces with cotton tipped applicators, pre-moistened with sterile saline and inoculated on Sabouraud dextrose or selective Eosin-Methylene Blue agar plates and incubated for 1 to 7 days at 28°C or 37°C in three triplications in order to isolate bacterial and fungal contaminants.Results: We isolated and identified gram-negative bacteria and fungi and the results showed that the predominant bacteria were; Klebsiella spp. Pseudomonas spp. and E coli spp. The predominant genera of fungi were; Cladosporium spp. Microsporum canis., Aspergillus spp. and Penicillium spp.Conclusions: This study showed that all areas of the hospital have pathogenic fungi and bacteria, indicating that these are a potential source of cross-infection from the hands of health care workers to their patients. Implication for health policy/practice/research/medical education:Identification of bacterial and fungal contamination in indoor surfaces would be the key elements in order to evaluate the effectiveness of aseptic techniques that can be applied and contribute to better preventive measures against infectious diseases caused by nosocomial pathogens.Please cite this paper as:Garcia-Cruz CP, Najera Aguilar MJ, Arroyo-Helguera OE. Fungal and Bacterial Contamination on Indoor Surfaces of a Hospital in Mexico. Jundishapur J Microbiol. 2012;5(3):460-4. DOI: 10.5812/jjm.2625 Copyright ©2012 Kowsar Corp. All rights reserved.

Microbiology of the white coat in a dental operatory

It remains important to have a thorough knowledge of the micro-flora harboring the white coats of doctors to minimize cross-contamination and improve patient safety by reducing the risk of nosocomial infections. This study presents the microbiological analysis of the white coats in clinical departments of a dental college and hospital. The swabs for the study were taken from the white coats of undergraduate students posted in various clinical departments, interns, and the post-graduate students. The microbial contamination was studied by observing and recording the colony morphology on the culture plates, Gram's staining with light microscopic screening of the slides, and the biochemical characterization of the isolates using standard microbiology protocols. Microbiological analysis of swabs taken from the white coats in the dental operatory showed that 100% coats had bacterial contamination. Out of 30 swabs collected, 46 cultures were obtained. 50% cultures showed Gram-positive cocci, making it the major microbial group contaminating the white coats in the dental operatory. The presented study highlights the fact that the white coats are a potential source of cross infection. The results of this study mandate a strict audit process and protocols to be set in place for preventing cross-contamination from the white coats in a dental operatory.

Filmcards Used in Radiation Therapy: Are They a Potential Source of Cross-infection?

IntroductionIndustrial radiographic film (exposed to light and then cut into a filmcard) is a tool used by radiation therapists (RTs) in the setup of patients before delivering external beam radiation therapy. At the Tom Baker Cancer Center (TBCC), filmcards are reused throughout the day on multiple patients and multiple body sites; thus the risk of cross-contamination exists. The primary objective of this study was to assess the risk of cross-contamination by determining the potential for bacteria to survive on filmcards, in an effort to reduce the risk of cross-infection. Methods and MaterialsThis control study evaluated the potential of the following to survive on filmcards: coliforms, Pseudomonas, Staphylococcus spp. (specifically S. aureus and methicillin-resistant S. aureus [MRSA]), Enterococcus, and hemolytic streptococcus species. Thirty filmcards used by RTs throughout the day were collected and voluntarily placed in individual collection bags. Thirty control cards (unused filmcards) were also collected. Collection bags were stored at 4°C until cultured. A reference strain of MRSA (38591) was used in the MRSA survival assay, along with methicillin-sensitive S. aureus (MSSA) isolate (pure form). The MRSA survival experiment required eight larger, unused filmcards (four designated as negative controls and four positive control cards) to be cut into 28.5 × 6.5 cm. Microbiological plates were used to identify and select for bacteria. The various selective and differential plates contain growth factors, antimicrobials, and color indicators that can selectively allow some groups of bacteria to grow on the plate while inhibiting other types of bacteria. ResultsThis study provides evidence to support that filmcards are a source of cross-contamination. 58% (17/29) of the used filmcards tested positive for pathogenic bacteria, compared to only 20% (6/30) of the control cards (P = 0.003). Staphylococcus aureus bacteria were present on 11/29 (38%) of the used filmcards, compared to 2/30 (6.7%) on the control filmcards (P = 0.005). Other colonies found on the used filmcards included strep bacteria (P = 0.24), entero bacteria (P = 0.24), and skin flora (P = 0.36); and although reported as statistically insignificant, these bacteria were viable and thus hold a level of clinical significance. In addition, this experiment provides evidence that certain bacteria (including MRSA found to survive on filmcards for at least 21 days) were viable on filmcards, but an incidental finding reports that fungi is also able to survive on filmcards. ConclusionFilmcards used by RTs can harbor a number of pathogenic bacteria, including MRSA, and are therefore a source of cross-contamination. We recommend that the TBCC external beam radiation treatment program–and any other facilities providing external beam radiation therapy–adopt infection control policies that support discarding filmcards after each use (one-time per patient use) or adopt policies that endorse the elimination of filmcards entirely.

Pelvic supports—potential source of cross-infection in hip surgery

Queen Elizabeth the Queen Mother Hospital, Margate, East Kent Hospitals NHS University Trust, UK. PURPOSE Surfaces of supports used to position patients for hip replacement are usually are in direct contact with the patient skin around the groin/buttock areas & repeated use of same supports, in trauma & elective surgeries, can be a source of cross-infection & wound contamination. MATERIALS AND RESULTS Swab samples from 12 supports, employed interchangeably for elective & trauma surgery. Cultured & incubated at 37 0 C in Columbia Blood Agar. 2 random supports cleaned using Sani Cloth Detergent non-alcoholic wipes & 2 samples were obtained from each support, 5 min later. 71% sampled supports were contaminated, with Coagulase-negative Staphylococcus, including Staph Epidermidis, being the most commonly grown organism with average of 5.3 colony forming units (CFU) (0-38) per swab. 5 min after cleaning 2 of above supports there was a 100% reduction in their contamination with no growth from the 4 swabs. CONCLUSION Trauma patients are not necessarily subjected to groin MRSA swabs pre-operatively in contrast to patients undergoing elective hip surgery who are rigorously swabbed for the same & interchangeable use of hip supports in trauma and elective patients defeats the purpose of this practice considering the fact that Coagulase -ve Staphylococci like Staph epidermidis, reside on the hip supports presently used in the orthopaedic theatre. We recommend strict cleaning of these supports for 5 min with the detergent wipes before & between every orthopaedic hip case & where feasible, the supports used should be different for elective and trauma cases.

Risk of bacterial cross infection associated with inspiration through flow-based spirometers

Bacterial contamination of spirometers has been documented in water-sealed devices, mouthpieces, and connection tubes. Little information is available about bacterial contamination of flow-based apparatuses such as turbine-type spirometers and pneumotachographs. Inspiration through contaminated equipment is a potential source of cross infection. To investigate bacteria mobilization (ie, bacteria detachment and aerosolization from the instrument) during routine spirometric testing, 2 types of flow-based spirometers were used. Bacteria mobilization during artificial inspiration through in-line filters or cardboard mouthpieces was evaluated. Nine hundred workers undergoing periodic spirometric testing were enrolled at the occupational physician office in 30sessions of 30 subjects each. The participants were asked to perform a forced vital capacity test in a turbine-type spirometer and in an unheated pneumotachograph fitted with disposable in-line filters or cardboard mouthpieces. To evaluate bacterial mobilization, an artificial inspiration was performed and bacterial growth determined. The bacterial growth analysis was assessed after the first and the thirtieth spirometric tests of each session without disinfecting the instruments between tests. In addition, instrument bacterial contamination was evaluated. No significant bacterial mobilization and instrument contamination were found in spirometric tests executed with in-line filters. Conversely, a significant bacterial mobilization and instrument contamination were observed in tests performed with cardboard mouthpieces. Differences between the 2 spirometers were not significant. In-line filters may effectively reduce the risk of bacterial cross infection. Inspiration through flow-based spirometers fitted with disposable cardboard mouthpieces is completely safe when combined with spirometer disinfection/sterilization between subjects.

Decontamination of laryngoscope blades

The laryngoscope has been identified as a potential source of cross-infection, because of blood and bacterial contamination. In India, there are no guidelines for cleaning and disinfection of anesthesia-related equipment. Practices for decontamination of laryngoscopes vary widely and in most healthcare institutes, laryngoscope blades are re-used after cleaning with tap-water. We prospectively compared two techniques for decontamination of laryngoscope blades - a) washing with tap-water and b) washing with tap-water followed by disinfection by immersing in 5% v/v (volume/volume, 1:20 dilution) aldehyde-free biguanide agent for 10 min. We calculated the cost-effectiveness of using 5% v/v aldehyde-free biguanide agent for disinfection of laryngoscopes. We also conducted a survey to assess the decontamination practices in other Indian hospitals. Overall bacterial growth was 58% (29 out of 50 blades) after tap-water cleaning (of which 60% were pathogenic organisms) versus 3.4% (one out of 29 blades) after tap-water cleaning followed by immersion in disinfectant (all of which were commensals). The cost of disinfection with biguanide was Indian Rupees 1.13 (20 US cents) per laryngoscope. Most hospitals in India do not have guidelines regarding laryngoscope decontamination between uses, and cleaning with tap water is a commonly used method. Cleaning of laryngoscope blades with tap-water is a commonly used but inadequate method for decontamination. Washing with tap-water followed by disinfection with 5% v/v aldehyde-free biguanide for at least 10 min is an effective and inexpensive alternative. National guidelines for the decontamination of anesthesia equipment are necessary.

Re-using intermittent pneumatic compression garments designed for single-patient-use is a potential source of cross-infection

Hospital acquired illnesses such as healthcare associated infection (HCAI) and venous thromboembolism (VTE) are often preventable; however, they occur frequently, are hugely expensive and cause increased patient morbidity and mortality. Intermittent pneumatic compression (IPC) has been proven to reduce the risk of patients developing a deep vein thrombosis (DVT). DVT prophylaxis IPC garments are designed to be single patient use, however anecdotally some hospitals re-use these products on multiple patients. This study examines the bacterial bio-burden present on IPC garments from three different manufacturers after an episode of single patient use and compares these results to a sample of unused (clean) garments. Sixty-one percent of used garments recorded >100 colony forming units (CFU) present on at least one sample plate, while the samples taken from unused garments reported either no growth (67%) or had very few organisms (less than five CFU) present (33%). IPC garment wear time and/or presence of graduated compression stockings worn beneath the garment had no impact on reducing the garment bio-burden. After an episode of single patient use, IPC garments carry a significant bio-burden and could be a source of pathogens. DVT prophylaxis IPC garments should be utilised as single patient use.

Microbial contamination of the white coats of dental staff in the clinical setting.

Background and aims Although wearing a white coat is an accepted part of medical and dental practice, it is a potential source of cross-infection. The objective of this study was to determine the level and type of microbial contamination present on the white coats of dental interns, graduate students and faculty in a dental clinic. Materials and methods Questionnaire and cross-sectional survey of the bacterial contamination of white coats in two predetermined areas (chest and pocket) on the white coats were done in a rural dental care center. Paired sample t-test and chi-square test were used for Statistical analysis. Results 60.8% of the participants reported washing their white coats once a week. Grading by the examiner revealed 15.7% dirty white coats. Also, 82.5% of the interns showed bacterial contamination of their white coats compared to 74.7% graduate students and 75% faculty members irrespective of the area examined. However, chest area was consistently a more bacterio-logically contaminated site as compared to the pocket area. Antibiotic sensitivity testing revealed resistant varieties of micro-organisms against Amoxicillin (60%), Erythromycin (42.5%) and Cotrimoxazole (35.2%). Conclusion The white coats seem to be a potential source of cross-infection in the dental setting. The bacterial contamina-tion carried by white coats, as demonstrated in this study, supports the ban on white coats from non-clinical areas.

An investigation of infection control for x-ray cassettes in a diagnostic imaging department

Introduction This research was conducted to investigate if X-ray cassettes could be a possible source of pathogens capable of causing nosocomial infections, and if they could be a possible vector for cross infection within the hospital environment. Method The research involved the swabbing of X-ray cassettes in a Diagnostic Imaging Department of a large hospital in the east of England. Two areas of the Diagnostic Imaging Department were included in the study. Research concentrated on X-ray cassettes used for mobile radiography, accident and emergency and inpatient use. Forty cassettes were swabbed in total specifically for general levels of bacterial contamination, also for the presence or absence of methicillin-resistant Staphylococcus aureus (MRSA). A mapping exercise was completed following the location of an X-ray cassette typically used in mobile radiography. The exercise noted the level of direct contact with patient's skin and other possible routes of infection. Results The results demonstrated that there were large levels of growth of samples taken from cassettes and developed in the Microbiology Department. Coagulase-negative Staphylococcus, Micrococci, Diptheroids and species of Bacillus were all identified. The mapping exercise in which the journey of a 35/43 cm cassette used for mobile radiography was tracked found that contact with patient's skin and potential pathogens or routes of cross infection was a common occurrence whilst undertaking mobile radiography. Conclusion The research has identified the presence of bacterial contamination on cassettes. The research established that X-ray cassettes/imaging plates are often exposed to pathogens and possible routes of cross infection; also that patient's skin often comes directly in contact with the X-ray cassette/imaging plate. The research also shows that as cassettes/imaging plates are a potential source of cross infection, the Diagnostic Imaging Department may be partly responsible for adding to the transference of pathogens around the hospital.