security swipe cards & scanners are potential reservoir for hospital aquired infection
DESCRIPTION
My 2nd presentation in the journal club in the applied medical sciences collage, UQU.TRANSCRIPT
Hibah Abdul- Wahab Abusulaiman
Collage of Applied Medical SciencesLaboratory Medicine
Microbiology DepartmentDecember 3rd, 2011
Who is he?
He invented…Steve Jobs
She invented…?
Who is she?
Ms. Lisa Holmes
I will Keep the Best Part for the End
You will Guess…
In her invention, she considered…
Smartcards, Credit Cards, Identification Cards, Healthcare Cards, Employee Badges, Rewards Cards, Chips, and Tokens and transmission of microbes and pathogens that thrive on there
surfaces.
A study speaks about…
It took the concern of…
The Presentation’s Outline
• The research problem.• The aim of the study.• Methodology.• Results.• Conclusion.• Critique.• Recommendation.• Ms. Lisa’s invention.
The Research Problem
The Aim of the Study
1• To determine if swipe cards and wall- mounted
scanners harbour potentially harmful bacteria
Methodology
• Sample:– Study population:
• 45 doctors working in the departments of: general, orthopaedic and urological surgery at the Queen Elizabith Hospital, Kings Lynn, UK.
• 39 consented and their security swipe cards.
– Scanners:• 16 swipe- cards scanners in that words.
Methodology
1• Questionnaire completion
2• Culturing participant’s swipe cards
3• Determining if swipe-cards scanners harbour bacteria
5• Assessing a single method for cleaning scanners
Methodology
To determine:– Where they kept their swipe card while working.– Frequency of its usage.– Clinical accessed areas through their cards in the past 24 hrs.– Frequency and methods of cleaning their cards.
1• Questionnaire completion:
Methodology
2• Culturing participant’s swipe cards:
Tryptone Soya Agar (TSA)
Aerobically at 36OC
for 24 hrs
at 30OC for 48 hrsIncubated
Methodology
3• Determining if swipe- cards scanners harbour bacteria
Using sterile swipe cards
TSA
Aerobically at 36OC
for 24 hrs
at 30OC for 48 hrsIncubated
Methodology
1. Scrubbing with soap and water for 30 seconds.2. Scrubbing with hibiscrub for 30 seconds.3. Cleaning with an alcohol- soaked swab for 15
seconds.
4• Assessing three methods of cleaning swipe cards:
TSA
Aerobically at 36OC
for 24 hrs
at 30OC for 48 hrs
Incubated
Methodology
5• Assessing a single method for cleaning scanners:
Using sterile swipe cards( drawn x3)
Cleaning
for 15 s
TSA
Aerobically at 36OC
for 24 hrs
at 30OC for 48 hrs
Incubated
MethodologyFollowing incubation:
Antibiotic Sensitivity Testing
(AST)
Detection of: S. aureus, MRSA, Enterococcus spp.,
coliforms and Pseudomonas spp.
Colony Count (CFU)
Results% in
respect to 39 participants Mean
number CFUs
Colonised with pathogenic bacteria:
n (%)
% of colonised with pathogenic bacteria in respect to the 39
participants
7320.5%
And 79.5% were environmental
bacteria
Grade
Consultant (n= 10)
25.64% 59 3 (30% ) 7.69%
Middle- grade (n= 13)
33.33% 92 5 (38% ) 12.82%
House officer (n= 16)
41.02% 68 -- 0%
Specialty
General surgery (n= 23)
58.97% 73 5 (22% ) 12.82%
Orhtopaedics (n= 12)
30.76% 84 2 (17% ) 5.12%
Urology (n= 4)
10.25% 46 1 (25% ) 2.56%
Results
% in respect to 39 participants
Mean number
CFUs
Colonised with pathogenic
bacteria: n (%)
% of colonised with pathogenic bacteria in
respect to the 39 participants
Frequency of use
Frequent (> 15 times/ wk) n= 19
48.71% 52 5 (26% ) 12.82%
Moderate (5- 15 times/ wk) n= 14
35.89% 86 3 (21% ) 7.69%
Occasional (< 5times/ wk) n= 6
15.38% 113 -- 0%
Where card kept
Necklace (n= 11) 28.20% 54 1 (9% ) 2.56%
Belt (n= 13) 33.33% 55 2 (15% ) 5.12%
Pocket (n= 15) 38.46% 108 5 (33% ) 12.82%
Card cleaned
Never (n= 32) 82.05% 83 6 (19% ) 15.38%
Yes (n= 7) 17.94% 29 2 (29% ) 5.12%
Results
• Overall, 8 (20.5%) were contaminated with potentially pathogenic bacteria including S. aureus, Pseudomonas putida and coliforms.
• One of the latter bacteria being resisitant to ampicillin.
Scanners Results
• Bacteria were cultured from 14 of 16 scanners (88%) examined.
• All the bacteria cultured were environmental pathogens.
• There was wide variation in the number of CFUs cultured from different scanners.
• The highest counts being obtained from scanners adjacent to main operating theaters, the day- surgery unit and the administration block.
Card Cleaning Results
• No bacteria were cultured from swipe cards following a 30s wash with hibiscrub or a 15s with an alcohol- soaked swab.
• 31 CFUs were cultured from cards cleaned by washing in soap and water for 30s.
Scanner Cleaning Results
• No bacteria were cultured from scanners following cleaning with alcohol swabs.
Conclusion
• The majority of cards and scanners were contaminated by environmental bacteria with low pathogenic potential.
• Bacteira with significant pathogenic potential, and implicated as causes of nosocomial infection were isolated from 20.5% of swipe cards.
Conclusion
• Two thirds of these 20.5% pathogenic contaminated cards were kept in wallets or pockets.
• Large numbers of bacteria were transferred from card to scanner, and scanner to card during experimental use.
Conclusion
• All contaminated cards were carried by consultants and middle- grade surgeons suggests that duration of use of a card may be of relevance.
• Previous cleaning of swipe cards by owners resulted in a notable, but non-significant, reduction in the number of CFUs isolated.
Conclusion
• Cleaning cards and scanners with alcohol in a controlled fashion effectively removed all bacteria.
Conclusion
• There is no corrolation between colonisation with pathogenic bacteria and any of the other recorded parameters, including how the cards was carried, frequency of use, areas of use and cleaning practice.
Critique
• The aim of the study was fully covered through its methodology.
Methodology Critique
• The three methods of cleaning the swipe cards were not well described.
• In the methodology: the researchers did not justify the fluctuation in incubation temperature.
Results CritiqueResults
Mean number CFUs
Colonised with pathogenic bacteria: n
(%)
% of colonised with pathogenic bacteria in
respect to the 39 participants
Grade
Consultant (n= 10)
59 3 (30% ) 7.69%
Middle- grade (n= 13)
92 5 (38% ) 12.82%
House officer (n= 16)
68 -- 0%
Specialty
General surgery (n= 23)
73 5 (22% ) 12.82%
Orhtopaedics (n= 12)
84 2 (17% ) 5.12%
Urology (n= 4)
46 1 (25% ) 2.56%
Author:
Insignificant
Significant
Results
Mean number CFUs
Colonised with pathogenic bacteria:
n (%)
% of colonised with pathogenic bacteria in
respect to the 39 participants
Frequency of use
Frequent (> 15 times/ wk) n= 19
52 5 (26% ) 12.82%
Moderate (5- 15 times/ wk) n= 14
86 3 (21% ) 7.69%
Occasional (< 5times/ wk) n= 6
113 -- 0%
Where card kept
Necklace (n= 11) 54 1 (9% ) 2.56%
Belt (n= 13) 55 2 (15% ) 5.12%
Pocket (n= 15) 108 5 (33% ) 12.82%
Card cleaned
Never (n= 32) 83 6 (19% ) 15.38%
Ever (n= 7) 29 2 (29% ) 5.12%
Results CritiqueAuthor:
Insignificant Significant
Results Critique
• Authors: “There is no correlation between colonisation with pathogenic bacteria and any of the other recorded parameters, including how the cards was carried, frequency of use, areas of use and
cleaning practice”.
• ↑Usage frequency→ ↓ Hiding card→ ↓Bacteria
Results Critique
• The study did not mention an exact number or percentage of each pathogenic bacteria isolated from cards.
Recommendations
• Always be sure of wearing such cards on a necklace or belt.
• Be aware of cleaning that card and its scanners with alcohol.
So what do you think she invented?
Ms. Lisa Holmes
Ms. Lisa Holmes
Any Questions?!
Hibah A. W. Abu-Sulaiman