Computer keyboard and mouse: An intervention study on methicillin-resistant staphylococcus aureus decontamination in 4 intensive care units

doi:10.1016/j.jcrc.2016.09.021

Journal of Critical Care

Volume 37, February 2017, Pages 266-267

https://doi.org/10.1016/j.jcrc.2016.09.021 Get rights and content

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Acknowledgments

We acknowledge the contribution of Dr Shuhua Ren (Hangzhou First People's Hospital), Dr Rong Lin (Women's Hospital School of Medicine Zhejiang University) and Dr Tieer Gan (the First Affiliated Hospital of Zhejiang Chinese Medicine University) for their assistance and support.

References (9)

V. Russotto et al.
ICU-acquired infections: it is not only about the number of patients per room
J Crit Care
(2016)
A.P. Wilson et al.
Computer keyboards and the spread of MRSA
J Hosp Infect
(2006)
T. Fukada et al.
Anaesthetists' role in computer keyboard contamination in an operating room
J Hosp Infect
(2008)
R. Jones et al.
Keyboard cleanliness: a controlled study of the residual effect of chlorhexidine gluconate
Am J Infect Control
(2015)

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Cited by (4)

Monitoring the effectiveness of daily cleaning practices in an intensive care unit (ICU) setting using an adenosine triphosphate (ATP) bioluminescence assay
2020, American Journal of Infection Control
Citation Excerpt :
In our study, the percentage of MDROs cultured from high-touch surfaces appears to be lower than previously reported by other studies. Prior studies reported recovery of a relatively high proportion of methicillin-resistant Staphylococcus aureus (MRSA) from ICU workstation keyboards (37% contamination) and ICU patient files (5% contamination).13,18 Similarly, relatively high proportions of VRE were recovered from hospital privacy curtains (42% contamination).11
The degree to which daily intensive care unit (ICU) cleaning practices impacts bacterial burden is controversial. The study aimed to assess the utility of using adenosine triphosphate (ATP) bioluminescence assays for monitoring effectiveness of daily cleaning in ICU environments.
We sampled 364 total samples from 57 patient rooms and 18 common areas in 3 medical ICUs over 12 weeks, before and after routine daily cleaning. Endpoints were ATP levels (relative light units, RLU) and bacterial bioburden (colony forming units, CFU).
High-touch surfaces in ICU patient rooms and common areas were contaminated before and after cleaning. Routine cleaning significantly reduced bacterial burden in patient rooms (0.14 log₁₀ CFU reduction, P = .008; 0.21 log₁₀ RLU reduction, P < .001) and in ICU common areas (1.18 log₁₀ CFU reduction, P < .001; 0.72 log₁₀ RLU reduction, P < .001). Among sites with colony counts >20 CFUs, the proportion of sites with ATP readings >250 RLU was significantly higher than those with ATP readings ≤250 RLU (90.0% vs 10.0%, P < .05).
Routine cleaning significantly reduced bacterial burden on ICU environment surfaces. Although not an alternative to culture methods, ATP assays may be a useful technique to provide rapid feedback on surface cleanliness in ICU settings.
Sequential enhanced cleaning eliminates multidrug-resistant organisms in general intensive care unit of a traditional Chinese medicine hospital
2017, Journal of Critical Care
Citation Excerpt :
Therefore, implementation of effective infection control measures in ICUs is imperative [16]. Our previous multicenter study found that bundle interventions may improve environmental cleaning and reduce the rate of MDROs detected in ICUs [13,17]. However, despite training of environmental service workers (ESWs), the high-touch surfaces around MRSA patients in ICUs were often not adequately cleaned and were even cross-contaminated after terminal disinfection [18].
Effective cleaning of surfaces within hospital wards is necessary to reduce pathogen transmission. We investigated the roles of sequential enhanced cleaning by culturing pathogens from high-touch surfaces in a general intensive care unit.
A before-after controlled study was conducted during a 17-month period in the 25-bed general intensive care unit. The study comprised a baseline period (period 1) and 4 sequential tiered interventions: each patient zone was wiped with a single clean microfiber cloth daily (period 2), fluorescent markers and adenosine triphosphate assay were used to monitor and provide feedback on the effectiveness of cleaning (period 3), wiping a single patient zone with 3 clean microfiber cloths daily (period 4), and withdrawal of the feedback (period 5).
Compared with period 1, the cultures of multidrug-resistant organisms from high-touch surfaces were reduced by 41.0% (prevalence ratio [OR] = 0.59, P < .001), 70.8% (OR = 0.29, P < .001), 82.6% (OR = 0.17, P < .001), and 70.8% (OR = 0.29, P < .0001) in the subsequent sequential interventions, respectively.
Adoption of fluorescent markers and adenosine triphosphate bioluminescence reduced environmental contamination. Use of 3 cleaning cloths for 1 patient zone was more effective compared with a single cloth.
Impact of multicenter unified enhanced environmental cleaning and disinfection measures on nosocomial infections among patients in intensive care units
2020, Journal of International Medical Research
What's on your keyboard? A systematic review of the contamination of peripheral computer devices in healthcare settings
2019, BMJ Open

^☆: Conflict of interest statement: The authors declare that they have no conflicts of interest.

^☆☆: Funding sources: The research was supported by a grant from Science and Technology Bureau of Hangzhou City (No.20130733Q32).

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LetterComputer keyboard and mouse: An intervention study on methicillin-resistant staphylococcus aureus decontamination in 4 intensive care units☆,☆☆

Section snippets

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J Crit Care

J Hosp Infect

J Hosp Infect

Am J Infect Control

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Computer keyboard and mouse: An intervention study on methicillin-resistant staphylococcus aureus decontamination in 4 intensive care units☆,☆☆