Department of Family Medicine, University of Washington, Seattle, Washington, USA.
Department of Information Systems & Business Analytics, Florida International University, Miami, Florida, USA.
BMJ Open. 2019 Mar 8;9(3):e026437. doi: 10.1136/bmjopen-2018-026437.
To determine the extent and type of microbial contamination of computer peripheral devices used in healthcare settings, evaluate the effectiveness of interventions to reduce contamination of these devices and establish the risk of patient and healthcare worker infection from contaminated devices.
Systematic review METHODS: We searched four online databases: MEDLINE, CINAHL, Embase and Scopus for articles reporting primary data collection on contamination of computer-related equipment (including keyboards, mice, laptops and tablets) and/or studies demonstrating the effectiveness of a disinfection technique. Pooling of contamination rates was conducted where possible, and narrative synthesis was used to describe the rates of device contamination, types of bacterial and viral contamination, effectiveness of interventions and any associations between device contamination and human infections.
Of the 4432 records identified, a total of 75 studies involving 2804 computer devices were included. Of these, 50 studies reported contamination of computer-related hardware, and 25 also measured the effects of a decontamination intervention. The overall proportion of contamination ranged from 24% to 100%. The most common microbial contaminants were skin commensals, but also included potential pathogens including methicillin-resistant, , vancomycin-resistantenterococci and . Interventions demonstrating effective decontamination included wipes/pads using isopropyl alcohol, quaternary ammonium, chlorhexidine or dipotassium peroxodisulfate, ultraviolet light emitting devices, enhanced cleaning protocols and chlorine/bleach products. However, results were inconsistent, and there was insufficient data to demonstrate comparative effectiveness. We found little evidence on the link between device contamination and patient/healthcare worker colonisation or infection.
Computer keyboards and peripheral devices are frequently contaminated; however, our findings do not allow us to draw firm conclusions about their relative impact on the transmission of pathogens or nosocomial infection. Additional studies measuring the incidence of healthcare-acquired infections from computer hardware, the relative risk they pose to healthcare and evidence for effective and practical cleaning methods are needed.
确定医疗机构中使用的计算机外围设备的微生物污染程度和类型，评估减少这些设备污染的干预措施的效果，并确定受污染设备导致患者和医护人员感染的风险。
系统评价。
我们在四个在线数据库（MEDLINE、CINAHL、Embase 和 Scopus）中搜索了报告计算机相关设备（包括键盘、鼠标、笔记本电脑和平板电脑）污染的原始数据收集的文章，以及证明消毒技术有效性的研究。在可能的情况下进行了污染率的汇总，并使用叙述性综合描述设备污染率、细菌和病毒污染类型、干预措施的有效性以及设备污染与人类感染之间的任何关联。
在 4432 条记录中，共有 75 项研究涉及 2804 台计算机设备。其中，50 项研究报告了计算机相关硬件的污染情况，25 项研究还测量了消毒干预措施的效果。污染的总体比例从 24%到 100%不等。最常见的微生物污染物是皮肤共生菌，但也包括潜在的病原体，包括耐甲氧西林金黄色葡萄球菌、耐万古霉素肠球菌和耐氯己定梭菌。证明有效的消毒干预措施包括使用异丙醇、季铵盐、氯己定或过二硫酸钾的擦拭巾/垫、紫外线发光装置、强化清洁方案和氯/漂白剂产品。然而，结果不一致，并且没有足够的数据证明比较有效性。我们发现设备污染与患者/医护人员定植或感染之间的联系的证据很少。
计算机键盘和外围设备经常受到污染；然而，我们的研究结果还不能让我们得出关于它们对病原体传播或医院感染相对影响的明确结论。需要进一步研究来测量来自计算机硬件的医源性感染的发生率、它们对医疗保健的相对风险以及有效和实用的清洁方法的证据。
