Contamination of mobile phones with Staphylococcus aureus: potential transmission to hands of nursing staff
Mobile phones are increasingly used by hospital clinical staff for communication in delivering medical care. Previous studies have demonstrated that these devices may become colonised, but cross-contamination between hands of healthcare workers (HCWs) and devices has not been well-established. Kanayama AK et al. (Am J Infect Control 2017; 45:929-931) investigated the genetic relatedness of bacteria found on mobile phones and bacteria residing on hands of HCWs.
Between August and September 2010, 221 mobile phones and palms and fingers of nursing staff in 23 wards of a Japanese university hospital were sampled for bacterial contamination. After plating, cultures were examined for the presence of Staphylococcus aureus. Pulsed-field gel electrophoresis (PFGE) was used to evaluate relatedness of S. aureus strains.
Of the 221 mobile phones studied, 16 (7.2%) were colonised with S. aureus. Of these, 5 isolates (31.3% of total) were methicillin-resistant S. aureus (MRSA). S. aureus was isolated from 55 of the 221 nurses’ palms or fingers (24.9%), of which 13 were MRSA. Both the mobile phone and palms or fingers of their user were concurrently positive for S. aureus in 11 instances. In 10 of these positive HCW-phone pairs, PFGE patterns were identical.
Findings demonstrate the presence of genetically identical isolates from mobile phones and hands of nurses, consistent with cross-contamination. It is possible that contact with contaminated devices after handwashing could lead to re-contamination of palms or fingers, and that this could increase risk of healthcare-associated infections. Hand hygiene should therefore be repeated after use of mobile phones and prior to patient contact.
Australian cluster of Burkholderia cenocepacia bloodstream infections attributed to contaminated gel used for ultrasound-guided central line insertion
Outbreaks of Burkholderia cenocepacia infection have previously been reported in association with contamination of medical equipment, medicines or the environment. Shaban RZ et al. (Am J Infect Control 2017; 45:954-958) report an outbreak of B. cenocepacia healthcare-associated infections in two Australian jurisdictions during 2017.
The initial isolate was identified in blood cultures of a patient from the intensive care unit at a Gold Coast hospital. Three additional patient isolates were identified at this facility. Interrogation of the Queensland statewide pathology reporting system yielded three further isolates in two other centres. Following communication via professional networks across Australia, 2 further isolates were identified at a Canberra hospital. Microbiologic investigation of sterile items suspected of contamination was subsequently performed
In total, 9 B. cenocepacia blood culture isolates were identified. A further 3 isolates from sterile collections of other bodily fluids were identified. Testing of 6 sachets of ultrasound gel from sterile ultrasound probe cover kits yielded heavy growth of B. cenosepacia. All isolates were confirmed by reference laboratories in Queensland or Australian Capital Territory. recA sequences and MLST typing confirmed relatedness of clinical isolates and isolates recovered from ultrasound gel. Clinical review of affected patients confirmed that they had recently had central lines placed using ultrasound guidance. Following TGA notification, product recall was performed.
Findings confirm the causative relationship between contaminated ultrasound gel and bloodstream infections in patients having ultrasound-guided central line insertion. A collaborative approach to identification of all cases was employed, underscoring the need for rapid notification and information dissemination systems at a national level.