McAleese T, Broderick J M, Stanley E, Curran R
St. James's Hospital, Dublin, Ireland.
Mater Misericordiae University Hospital, Dublin, Ireland.
J Orthop. 2020 Jun 19;22:300-303. doi: 10.1016/j.jor.2020.06.010. eCollection 2020 Nov-Dec.
Thyroid radiation shields are often uncovered by the surgical gown and may represent a preventable source of wound contamination. The aims of this study are to define the common pathogens found on thyroid radiation shields and evaluate the effectiveness of a simple cleaning method.
Samples were obtained from 29 community thyroid shields collected from the operating theatres of 3 teaching hospitals. Each shield was swabbed under strict sterile technique using a separate swab for each of 4 designated zones. After sampling, shields were cleaned with a readily available disinfectant and sampling was repeated after 5 min. All swabs were cultured in ambient air at 37 °C on 5% sheeps blood agar for 48 hrs and subsequent growth was identified by a MALDI-TOF Walkaway mass spectrometer.
Before cleaning, 100% of thyroid shields (29/29) and 68% of shield zones (79/116) grew at least 1 type of bacteria. Coagulase negative staphylococci, including and , were most commonly isolated. and were also cultured. After cleaning, culturable contamination was reduced by 86.3% and 64.5%, respectively (p < 0.001).
The most common pathogens associated with SSIs can be isolated on thyroid radiation shields. Appropriate cleaning of thyroid shields with readily available disinfectant can significantly reduce the bacterial burden as detectable by culture. Hospitals should facilitate staff education and reinforce their policies on cleaning these shields which may often be overlooked.
甲状腺辐射防护屏常常会被手术衣盖住,可能是伤口污染的一个可预防来源。本研究的目的是确定在甲状腺辐射防护屏上发现的常见病原体,并评估一种简单清洁方法的有效性。
从3家教学医院的手术室收集的29个社区甲状腺防护屏上获取样本。每个防护屏在严格无菌技术下用拭子擦拭,4个指定区域各用一个单独的拭子。采样后,用一种现成的消毒剂清洁防护屏,并在5分钟后重复采样。所有拭子在37°C的环境空气中于5%羊血琼脂上培养48小时,随后通过MALDI-TOF Walkaway质谱仪鉴定生长的细菌。
清洁前,100%的甲状腺防护屏(29/29)和68%的防护屏区域(79/116)至少培养出1种细菌。凝固酶阴性葡萄球菌,包括 和 ,是最常分离出的。 和 也被培养出来。清洁后,可培养的污染物分别减少了86.3%和64.5%(p < 0.001)。
与手术部位感染相关的最常见病原体可在甲状腺辐射防护屏上分离出来。用现成的消毒剂对甲状腺防护屏进行适当清洁可显著降低培养可检测到的细菌负荷。医院应促进员工教育,并加强关于清洁这些常常被忽视的防护屏的政策。