Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.
Emerg Med Australas. 2013 Jun;25(3):222-6. doi: 10.1111/1742-6723.12076. Epub 2013 May 20.
Blood pressure (BP) cuffs are potential vectors for transmission of multi-resistant organisms (MROs). The present study aims to determine MRO colonisation rates in BP cuffs from areas of high patient flow as an assessment of the quality of disinfection and infection control practices.
BP cuffs in the ED, high dependency unit (HDU) and operating theatres (OT) were prospectively examined after routine disinfection procedures. Swabs collected from the inner and outer surfaces of BP cuffs during inter-patient intervals were plated onto replicate organism detection and counting, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) chromogenic agar plates to detect rates of bacterial, MRSA and VRE colonisation, respectively.
High bacterial colonisation rates were detected in BP cuffs from all three areas. BP cuffs from OT were significantly less colonised compared with cuffs from HDU and ED; 76% versus 96% and 100% (P < 0.0001) for inner surfaces and 86% versus 98% and 100% (P < 0.0001) for outer surfaces, respectively. Equivalent or higher bacterial growth was observed on the inner surface compared with outer surface in 54%, 84% and 86% of BP cuffs from OT, HDU and ED, respectively. MRSA was detected in 3 of 150 (2%) swabs collected, but no VRE was detected.
Although MRSA and VRE were infrequently isolated, current disinfection and infection control protocols need to be improved given the greater recovery of organisms from the inner compared with outer surfaces of BP cuffs.
血压袖带是多重耐药菌(MRO)传播的潜在载体。本研究旨在通过测量血压袖带的 MRO 定植率,评估其消毒质量和感染控制措施。
在常规消毒程序后,对 ED、HDU 和手术室(OT)的血压袖带进行前瞻性检查。在患者间隙,从血压袖带的内、外表面采集拭子,分别接种到复制物检测和计数平板、耐甲氧西林金黄色葡萄球菌(MRSA)和万古霉素耐药肠球菌(VRE)显色琼脂平板上,以检测细菌、MRSA 和 VRE 的定植率。
所有三个区域的血压袖带均检测到高细菌定植率。OT 血压袖带的定植率明显低于 HDU 和 ED;内表面分别为 76%比 96%和 100%(P<0.0001),外表面分别为 86%比 98%和 100%(P<0.0001)。OT、HDU 和 ED 的血压袖带内表面的细菌生长率与外表面相当或更高,分别为 54%、84%和 86%。从 150 个拭子中检测到 3 个(2%)MRSA,但未检测到 VRE。
尽管 MRSA 和 VRE 的检出率较低,但鉴于血压袖带内表面比外表面更易从组织中分离出更多的细菌,当前的消毒和感染控制方案需要改进。