Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Apr 29;8(1):Doc07.
doi: 10.3205/dgkh000207. eCollection 2013.

Microbial contamination of manually reprocessed, ready to use ECG lead wire in intensive care units

Trisasi Lestari  1 , Sylvia Ryll, Axel Kramer
Affiliations

Microbial contamination of manually reprocessed, ready to use ECG lead wire in intensive care units

Trisasi Lestari et al. GMS Hyg Infect Control. .

Abstract
in English, German

Background: A number of studies have shown that non-critical medical devices can be contaminated with pathogens, including those resistant to antibiotics and thus become a potential vector for transmission. Electrocardiography (ECG) lead wire are non-critical medical device which are always attached on patient skin during their stay in intensive care unit (ICU). In view of the patient's critical conditions and exposure to invasive procedures, identification and prevention of possible risks are important to prevent infection in ICUs.

Objective: The objective of this study was to determine the presence of bacterial and fungal contamination on cleaned and disinfected reusable ECG lead wires in intensive care units in a hospital.

Methods: A total of 408 cleaned ECG lead wires from 93 bed-side ECG devices and 43 ECG lead wires from 5 portable ECG devices from 4 intensive care units (ICUs) and 1 post-anaesthesia care unit (PACU) were sampled. ECG lead wires were stirred in 0.89% NaCl with added neutralizer for 30 seconds. Samples of the solutions were cultured directly on blood agar. The remaining solution was cultured on blood agar after sterile filtration. The number of colony forming units (CFUs) was counted and the microorganisms were identified.

Results: More than half of examined ECG lead wires (n=232; 51.4%) were contaminated with >30 CFUs/mL sample of bacteria or with risk pathogens. Gram-positive bacteria were the most frequently isolated organisms; particularly, coagulase negative staphylococci (96%) and aerobic spore forming bacteria (71.2%). Compared to ICUs, PACU had significantly lower proportion of contaminated ECG lead wires (p<0.05). The proportion of contaminated ECG lead wires, as well as mean number of cfus per ECG lead wire, was also significantly lower among multi-wire ECG leads compared to single-wire ECG leads.

Conclusions: Manually cleaned ECG lead wires may serve as a vector for transmission of nosocomial pathogens. The current reprocessing technique for ECG lead wires needs to be improved.

Hintergrund: In verschiedenen Studien konnte eine Kontamination unkritischer Medizinprodukte mit Pathogenen einschließlich multiresistenten Erregern nachgewiesen werden, die eine potentielle Quelle Health-Care assoziierter Infektionen darstellen. Ein derartiges unkritisches Medizinprodukt ist das EKG-Gerät. Da es z.B. auf der Intensivtherapiestation in Kontakt zur Haut des Patienten kommt und dadurch Pathogene unter kritischen Bedingungen bzw. im Rahmen invasiver Eingriffe Infektionen auslösen können, muss dieses Risiko ausgeschaltet werden.Zielsetzung: In der Studie sollte die mikrobielle Kontamination manuell aufbereiteter EKG-Anschlussklemmen auf Intensivtherapiestationen untersucht werden.Methode: Auf vier Intensivtherapieeinheiten (ITS) und einer Aufwacheinheit (PACU) wurden 408 bzw. 43 manuell aufbereitete EKG-Anschlussklemmen von 93 bettseitigen bzw. von 5 transportablen EKG-Geräten auf bakterielle und fungielle Kontamination untersucht. Nach 30 s Ausschütteln in 0,89%-iger NaCl-Lösung mit Zusatz eines Neutralisators wurden die Flüssigkeit direkt und zusätzlich nach Sterilfiltration auf Blutagar kultiviert, die Anzahl Kolonie bildender Einheiten (KbE) ermittelt und die Erreger differenziert. Ergebnisse: Mehr als die Hälfte der Anschlussklemmen (51,4%) war mit ≥30 KbE/ ml oder mit kritischen Pathogenen kontaminiert. Am häufigsten wurden Gram-positive Bakterien nachgewiesen, besonders Coagulase negative Staphylokokken (96%) and aerobe Sporenbildner (71,2%). Verglichen mit den ITS war der Anteil kontaminierter Anschlussklemmen auf der PACU signifikant geringer (p<0.05). Der Anteil kontaminierter Anschlussklemmen und die Höhe der Kontamination war signifikant geringer bei Mehrweganschlussklemmen im Vergleich zu single-use Anschlussklemmen.Schlussfolgerung: Manuell aufbereitete EKG-Anschlussklemmen sind ein Reservoir für nosokomiale Pathogene. In Auswertung der Befunde wurde die manuelle Aufbereitung durch eine maschinelle Aufbereitung ersetzt.

Keywords: ECG lead wire; ICU; PACU; microbial contamination.

PubMed Disclaimer

Figures

Table 1
Table 1. Types of determined bacteria
Table 2
Table 2. Proportion of contaminated ECG leads
Table 3
Table 3. Average number of bacterial colonies
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Pittet D, Allegranzi B, Storr J, Bagheri Nejad S, Dziekan G, Leotsakos A, Donaldson L. Infection control as a major World Health Organization priority for developing countries. J Hosp Infect. 2008 Apr;68(4):285–292. doi: 10.1016/j.jhin.2007.12.013. Available from: http://dx.doi.org/10.1016/j.jhin.2007.12.013. - DOI - DOI - PubMed
    1. Collins AS. Preventing health care-associated infections. In: Hughes RG, editor. Patient safety and quality: an evidence-based handbook for nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); Apr, 2008. p. Chapter 41. - PubMed
    1. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol. 2011 Feb;32(2):101–114. doi: 10.1086/657912. Available from: http://dx.doi.org/10.1086/657912. - DOI - DOI - PubMed
    1. Ranji SR, Shetty K, Posley KA, Lewis R, Sundaram V, Galvin CM, Winston LG. Prevention of healthcare-associated infections. Rockville, MD: Agency for Healthcare Research and Quality; 2007. (Closing the quality gap: a critical analysis of quality improvement strategies; 6). Available from: http://www.ncbi.nlm.nih.gov/books/NBK43982/ - PubMed
    1. Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K EPIC II Group of Investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009 Dec 2;302(21):2323–2329. doi: 10.1001/jama.2009.1754. Available from: http://dx.doi.org/10.1001/jama.2009.1754. - DOI - DOI - PubMed