Healthcare Hygiene magazine January 2020 | Page 23

Microbes recovered
from keyboards had
counts ranging from
6 CFU per key to
430 CFU per key.
Mold was detected
on 22 keyboards,
ranging from a
maximum of
120 CFU per key,
while yeast was found
on 17 keyboards up to
a maximum of
420 CFU per key.
A. baumannii, extended- spectrum ß-lactamase
(ESBL)–producing Klebsiella pneumoniae, Entero-
bacter aerogenes, and MRSA.
Rectal thermometers served as a fomite for out-
breaks of Enterobacter cloacae, VRE, Clostridium
difficile, and ESBL-producing K. pneumoniae, while
contaminated ultrasound gels led to B. cepacia
infection and bacteremia, S. aureus pyoderma,
or Mycobacterium massiliense surgical site in-
fection, while contamination of transesophageal
echocardiography (TEE) probes was involved in
outbreaks of E. cloacae, S. marcescens, and MDR
P. aeruginosa. Legionella pneumophila pneumonia
cases were also associated with contaminated
water to rinse TEE probes.
Outbreaks of S. marcescens, New Delhi metal-
lo-ß-lactamase (NDM)–producing E. cloacae, and
P. aeruginosa were associated with contamination
of refillable liquid soap or antibacterial soap dis-
pensers, facilitating transmission of the pathogen
via hands of healthcare personnel.
Healthcare-associated outbreaks via stetho-
scope occurred in combination with other reser-
voirs ( artificial nails, computer mouse, ointment,
sink, other environment) and were caused by
A. baumannii, ESBL-producing K. pneumoniae,
K. pneumoniae bacteremia. metallo-ß-lact-
amase (VIM)–producing carbapenem-resistant
P. aeruginosa.
Outbreaks of C. difficile infection in non-isola-
tion rooms or Chryseobacterium meningosepticum
infection in neonates and pediatric patients
implicated computer keyboards and other medical
equipment. Contamination with multiple patho-
gens had been identified on computer keyboards,
mobile phones, and tablets, and may be one of
the most-studied class of fomites.
As Messina, et al. (2011) found, microbes
recovered from keyboards had counts ranging
from 6 CFU per key to 430 CFU per key. Mold
was detected on 22 keyboards, ranging from a
maximum of 120 CFU per key, while yeast was
found on 17 keyboards up to a maximum of 420
CFU per key. Staphylococci were found on all
keyboards but one at counts up to 120 CFU per
key. S aureus was significantly more common on
shared keyboards than on nonshared keyboards.
As the researchers note, “Sources of bacterial
contamination can include poor hand hygiene
and droplets of saliva that inevitably fall on the
keyboard during talking, sneezing, and coughing.
Thus, to reduce the resident population of mi-
crobes with pathogenic potential, it is advisable to
observe the general rules of hygiene and to clean
keys frequently. To prevent transfer of bacteria to
and from keyboards via users’ hands, thorough
handwashing before and after keyboard contact is
recommended. Handwashing is often considered
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