January 12, 2024
2 min read
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Key takeaways:
- A study identified microbial contamination on numerous high-touch hospital surfaces, including CPR mannequins.
- Contaminated high-touch surfaces pose a risk to patient health, researchers said.
A new study identified several well-known hospital surfaces as potential sources of infection: bed rails, keyboards, rolling workstations and breakroom tables all harbored pathogenic bacteria, even after recommended cleaning.
In addition, the study uncovered a potentially new source of infection: CPR mannequins used for training.
Data derived from Jinadatha C, et al. Am J Infect Control. 2024;doi:10.1016/j.ajic.2023.11.006.
Among all the hospital surfaces tested in the study, CPR mannequins harbored the most diverse types of bacteria, according to findings reported in the American Journal of Infection Control.
The Texas hospital where the study was conducted requires health care workers to be tested four times a year on their chest compression and airway management competency using the mannequins.
Although patients do not come in contact with them, CPR mannequins could potentially be a source of health care-associated infections (HAIs) if they are not disinfected properly or workers do not clean their hands after training, the researchers said.
“It is a continuing frustration to health care professionals that HAIs persist despite rigorous attention to disinfection practices,” Piyali Chatterjee, PhD, a research scientist at Central Texas Veterans Healthcare System, said in a press release publicizing the findings.
“Our study clearly shows the bioburden associated with high-touch hospital surfaces — including simulation mannequins, which are not typically regarded as a risk because patients rarely touch them — and indicates that we must do better in protecting the health of our patients and our hospital employees,” Chatterjee said.
For the study, Chatterjee and colleagues sampled high-touch surfaces in a surgical unit at a VA hospital in Temple, Texas, and cross-referenced the results with patient isolates from the local microbiology database to identify clinical matches.
They surveyed five infectious disease physicians and a clinical microbiologist to determine whether bacteria found on the surfaces were “well known” or “not well known.”
The researchers sampled each surface 80 times between June and July 2022, collecting the specimens in the afternoon. The sampling uncovered 60 different types of bacteria, including 18 identified as “well known” but only seven that the CDC has classified as important in the health care setting. The microbiology lab identified 29 of the 60 pathogens in patient samples.
Among the 60 bacteria, 43 were gram positive, 16 were gram negative and one was gram variable. The common types of well-known bacteria included Enterococcus, Staphylococcus aureus — including MRSA — Streptococcus, Escherichia coli, Klebsiella aerogenes and Pseudomonas aeruginosa.
Mannequins and bed rails were the most contaminated surfaces and harbored the largest variety of bacteria — around one-third of the 60 organisms were recovered from each — followed by rolling workstation handles, breakroom tables and nurse station keyboards.
According to Chatterjee and colleagues, each location was cleaned at various intervals using a hydrogen peroxide-based disinfectant: bed rails upon patient discharge; nurses’ keyboards daily or as needed, mannequins between use, breakroom tables once daily and workstation handles daily.
“Over the years, our understanding of health care surface contamination and its contribution to HAIs has improved,” Chatterjee and colleagues wrote. “Consequently, emphasis has been directed to cleaning and disinfection of hospital surfaces, thereby limiting the spread of microorganisms that cause HAIs. However, due to inadequate cleaning and disinfection of environmental surfaces, along with the rise of disinfectant-resistant organisms, HAIs are still a burden to the U.S. health care system.”
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