Mehmood Zara, Mubeen Syed Muhammad, Afzal Muhammad Shehzad, Hussain Zainab
Hamdard College of Medicine and Dentistry, Karachi, Pakistan.
Department of Community Health Sciences, Hamdard College of Medicine and Dentistry, Karachi, Pakistan.
Int J Prev Med. 2014 Sep;5(9):1119-24.
Tourniquets used repeatedly on patients for blood sampling are a potential source of nosocomial infections. They harbor numerous microorganisms, including methicillin-resistant Staphylococcus aureus (MRSA). The aim of this study was to investigate tourniquets for the presence of microorganisms and to ascertain the infection control practices of health care workers.
A cross-sectional study was carried out in 2012 on 100 samples of tourniquets collected from public and private sector hospitals in Karachi, Pakistan. The samples were cultured, and pathogenic microorganisms were identified and tested for methicillin resistance. A questionnaire was administered simultaneously to 100 health care workers who had used the tourniquets. Descriptive data are represented as frequencies and percentages. Ethical considerations were taken into account.
The total colonization rate was 51%, with no bacterial growth in 17/40 and 32/60 samples from public and private sector hospitals, respectively. S. aureus was isolated from 12 (42%) private sector hospital samples and 10 (43%) public sector hospital samples. Although MRSA was found in more samples from public than private sector hospitals, the difference was not statistically significant. Nevertheless, 90% of all elastic and 41% of all rubber tourniquets harbored microorganisms (P < 0.001). Although 96% of health care workers agreed that hospital staff and fomites can transmit infection, none identified tourniquets as a potential source. When asked whether tourniquets appeared clean before use, 66% agreed, and only 25% considered that tourniquets should be washed or cleaned before use.
Tourniquets are a potential reservoir and vehicle for the spread of nosocomial infections, including MRSA. Health care workers have inadequate knowledge about infection control procedures and personal hygiene for disinfecting reusable items.
反复用于患者采血的止血带是医院感染的潜在来源。它们携带多种微生物，包括耐甲氧西林金黄色葡萄球菌（MRSA）。本研究的目的是调查止血带中微生物的存在情况，并确定医护人员的感染控制措施。
2012年对从巴基斯坦卡拉奇公立和私立医院收集的100份止血带样本进行了横断面研究。对样本进行培养，鉴定致病微生物并检测其对甲氧西林的耐药性。同时对100名使用过这些止血带的医护人员进行问卷调查。描述性数据以频率和百分比表示。研究考虑了伦理因素。
总定植率为51%，公立和私立医院的样本分别有17/40和32/60未检测到细菌生长。从12份（42%）私立医院样本和10份（43%）公立医院样本中分离出金黄色葡萄球菌。虽然公立医院样本中发现MRSA的比例高于私立医院，但差异无统计学意义。然而，所有弹性止血带中有90%、所有橡胶止血带中有41%携带微生物（P<0.001）。虽然96%的医护人员同意医院工作人员和污染物可传播感染，但无人认为止血带是潜在来源。当被问及止血带在使用前是否看起来干净时，66%的人表示同意，只有25%的人认为止血带在使用前应清洗。
止血带是包括MRSA在内的医院感染传播的潜在储存库和传播媒介。医护人员对感染控制程序和可重复使用物品消毒的个人卫生知识不足。
