Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii on computer interface surfaces of hospital wards and association with clinical isolates

BackgroundComputer keyboards and mice are potential reservoirs of nosocomial pathogens, but routine disinfection for non-water-proof computer devices is a problem. With better hand hygiene compliance of health-care workers (HCWs), the impact of these potential sources of contamination on clinical infection needs to be clarified.MethodsThis study was conducted in a 1600-bed medical center of southern Taiwan with 47 wards and 282 computers. With education and monitoring program of hand hygiene for HCWs, the average compliance rate was 74% before our surveillance. We investigated the association of methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Acinetobacter baumannii, three leading hospital-acquired pathogens, from ward computer keyboards, mice and from clinical isolates in non-outbreak period by pulsed field gel electrophoresis and antibiogram.ResultsOur results revealed a 17.4% (49/282) contamination rate of these computer devices by S. aureus, Acinetobacter spp. or Pseudomonas spp. The contamination rates of MRSA and A. baumannii in the ward computers were 1.1% and 4.3%, respectively. No P. aeruginosa was isolated. All isolates from computers and clinical specimens at the same ward showed different pulsotypes. However, A. baumannii isolates on two ward computers had the same pulsotype.ConclusionWith good hand hygiene compliance, we found relatively low contamination rates of MRSA, P. aeruginosa and A. baumannii on ward computer interface, and without further contribution to nosocomial infection. Our results suggested no necessity of routine culture surveillance in non-outbreak situation.

[1]  J. Wagenvoort,et al.  Better environmental survival of outbreak vs. sporadic MRSA isolates. , 2000, The Journal of hospital infection.

[2]  B. Oppenheim,et al.  Improved recognition of MRSA case clusters by the application of molecular subtyping using pulsed-field gel electrophoresis. , 1999, The Journal of hospital infection.

[3]  G. Warden,et al.  Computer keyboards as reservoirs for Acinetobacter baumannii in a burn hospital. , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  L. Donowitz,et al.  The Inanimate Environment of an Intensive Care Unit as a Potential Source of Nosocomial Bacteria: Evidence for Long Survival of Acinetobacter calcoaceticus , 1989, Infection Control & Hospital Epidemiology.

[5]  L. Sehulster,et al.  Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). , 2003, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[6]  Didier Pittet,et al.  Guideline for Hand Hygiene in Health-Care Settings Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC / SHEA / APIC / IDSA Hand Hygiene Task Force , 2002 .

[7]  Didier Pittet,et al.  Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. , 2002, American journal of infection control.

[8]  R. Cooke,et al.  Is methicillin-resistant Staphylococcus aureus (MRSA) contamination of ward-based computer terminals a surrogate marker for nosocomial MRSA transmission and handwashing compliance? , 2001, The Journal of hospital infection.

[9]  A. Harris,et al.  How important is the environment in the emergence of nosocomial antimicrobial-resistant bacteria? , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  M. Ferraro.  Performance standards for antimicrobial susceptibility testing , 2001 .

[11]  M. Chadwick,et al.  Bacterial contamination of ward-based computer terminals. , 2002, The Journal of hospital infection.

[12]  D H Persing,et al.  Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing , 1995, Journal of clinical microbiology.

[13]  A Peter R Wilson,et al.  Laboratory and in-use assessment of methicillin-resistant Staphylococcus aureus contamination of ergonomic computer keyboards for ward use. , 2008, American journal of infection control.

[14]  Robert A. Weinstein,et al.  Contamination, Disinfection, and Cross-Colonization: Are Hospital Surfaces Reservoirs for Nosocomial Infection? , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  Hugo Sax,et al.  Evidence-based model for hand transmission during patient care and the role of improved practices. , 2006, The Lancet. Infectious diseases.

[16]  S. Dancer,et al.  Importance of the environment in meticillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning. , 2008, The Lancet. Infectious diseases.

[17]  S. Iyobe,et al.  Detection of carbapenemase-producing Acinetobacter baumannii in a hospital. , 2000, Journal of clinical microbiology.

[18]  R. Röhrig,et al.  Computer Keyboard and Mouse as a Reservoir of Pathogens in an Intensive Care Unit , 2003, Journal of Clinical Monitoring and Computing.

[19]  J. Parker,et al.  Computer keyboards and faucet handles as reservoirs of nosocomial pathogens in the intensive care unit. , 2000, American journal of infection control.

[20]  William A Rutala,et al.  Bacterial Contamination of Keyboards: Efficacy and Functional Impact of Disinfectants , 2006, Infection Control & Hospital Epidemiology.

[21]  B. Oppenheim,et al.  A Study of the Relationship Between Environmental Contamination with Methicillin-Resistant Staphylococcus aureus (MRSA) and Patients' Acquisition of MRSA , 2006, Infection Control & Hospital Epidemiology.

[22]  T. Kirikae,et al.  Molecular epidemiology of outbreaks and containment of drug-resistant Pseudomonas aeruginosa in a Tokyo hospital , 2007, Journal of Infection and Chemotherapy.

[23]  T. Stibolt,et al.  Multiple intensive care unit outbreak of Acinetobacter calcoaceticus subspecies anitratus respiratory infection and colonization associated with contaminated, reusable ventilator circuits and resuscitation bags. , 1988, The American journal of medicine.

[24]  C. Donskey,et al.  Acquisition of Nosocomial Pathogens on Hands After Contact With Environmental Surfaces Near Hospitalized Patients , 2004, Infection Control & Hospital Epidemiology.

[25]  A. Rampling,et al.  Evidence that hospital hygiene is important in the control of methicillin-resistant Staphylococcus aureus. , 2001, The Journal of hospital infection.

[26]  R. D. McCormick,et al.  Effect of education and performance feedback on handwashing: the benefit of administrative support in Argentinean hospitals. , 2003, American journal of infection control.

[27]  M. Exner,et al.  Pseudomonas aeruginosa outbreak in a haematology-oncology unit associated with contaminated surface cleaning equipment. , 2002, The Journal of hospital infection.

[28]  A. Neely,et al.  Computer equipment used in patient care within a multihospital system: recommendations for cleaning and disinfection. , 2005, American journal of infection control.

[29]  F. Gordin,et al.  Bacterial Contamination of Computer Keyboards in a Teaching Hospital , 2003, Infection Control & Hospital Epidemiology.

[30]  J. Boyce,et al.  Environmental Contamination Due to Methicillin-Resistant Staphylococcus aureus Possible Infection Control Implications , 1997, Infection Control & Hospital Epidemiology.