The undisputed versatility of smart devices makes them integral to modern-day society , especially within our National Health System . Despite the benefits , there are increasing concerns regarding their contamination and the associated infection risk .”
In this study , Redmond , et al . ( 2020 ) point out that a better understanding of the routes of pathogen transmission is needed to develop effective control measures , especially in light of the spread of healthcare-associated pathogens such as Clostridioides difficile and methicillin-resistant Staphylococcus aureus ( MRSA ).
The researchers , from the Northeast Ohio VA Healthcare System , closely tracked contamination in hospital rooms of 17 newly admitted patients to identify the timing and route of transfer of bacteria within patients ’ rooms . Before testing , rooms were thoroughly cleaned and sanitized and all patients screened negative for methicillin-resistant Staphylococcus aureus ( MRSA ) and other healthcare-associated bacteria . Researchers then observed patients ’ interactions with healthcare personnel and portable equipment , collecting cultures one to three times per day from patients , their socks , beds and other high-touch surfaces , as well as key sections of the floor . Nearly half of rooms tested positive for MRSA within the first 24 hours , and MRSA , C . difficile , and vancomycin-resistant enterococci ( VRE ) pathogens were identified in 58 percent of patient rooms within four days of admission . Contamination often started on the floors , but ultimately moved to patients ’ socks , bedding and nearby surfaces . For the 17 patients enrolled , one or more environmental cultures became positive for MRSA in rooms of 10 patients ( 59 percent ), for C . difficile in rooms of two patients ( 12 percent ) and for VRE in rooms of two patients ( 12 percent ). The patients interacted with an average of 2.4 personnel and 0.6 portable devices per hour of observation .
MRSA contamination of the floor occurred rapidly as personnel entered the room . In a subset of patients , MRSA was subsequently recovered from patients ’ socks and bedding and ultimately from the high-touch surfaces in the room ( tray table , call button , bedrail ). For several patients , MRSA isolates recovered from the floor had the same spa type as isolates subsequently recovered from other sites ( eg , socks , bedding , and / or high-touch surfaces ). The direct transfer of healthcare-associated pathogens from personnel or equipment to high-touch surfaces was not detected . The researchers emphasized that healthcare-associated pathogens rapidly accumulate on the floor of patient rooms and can be transferred to the socks and bedding of patients and to high-touch surfaces . They add that healthcare facility floors may be an underappreciated source of pathogen dissemination not addressed by current infection control measures .
“ While we ’ re showing that these scary sounding bugs can make their way into a patient ’ s room and near them , not everyone who encounters a pathogen will get an infection ,” says Sarah Redmond , lead author and a medical student at Case Western Reserve University School of Medicine . “ With that in mind , are there simple ways to address these areas of exposure without placing too much emphasis on the risk ?”
In a related study published in August 2020 in Infection Control & Hospital Epidemiology , the authors reported similar findings of frequent detection of SARS-CoV-2 nucleic acid on floors and on shoes of personnel on a COVID-19 ward . The authors note that further research is needed to clarify the role of floor contamination in transmission of both bacterial and viral pathogens and to identify practical approaches to address contamination . On the COVID-19 ward , contamination was reduced with simple modifications of floor cleaning and disinfection protocols .
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Simmonds ( 2020 ) reminds us of the transmission risks posed by objects that move about the healthcare institution . As she acknowledges , “ The undisputed versatility of smart devices makes them integral to modern-day society , especially within our health system . Despite the benefits , there are increasing concerns regarding their contamination and the associated infection risk . Bacteria under antimicrobial selective pressure can rapidly acquire resistant mechanisms leading to the assumption ; mobile phones used within clinical environments may harbor bacteria associated with a higher infection mortality rate .” Using next-generation sequencing technology , Simmonds ( 2020 ) characterized the true extent of bacterial contamination on mobile devices of hospital staff to determine the level of antimicrobial resistance within Staphylococcus aureus and Enterococcus faecalis . Smart phones of 250 hospital staff and 191 control group participants were swabbed over a six-month period . Nearly all mobile devices were contaminated with potential pathogens regardless of environment . Metabarcoding revealed far greater bacterial diversity and abundance of gram-negative bacterial contamination than did culture-based methods . In total , 198 bacterial genera of were discovered across both groups , of which 34 were unique to the hospital . Bacillus was significantly higher within the hospital group ( P = . 036 ). Differences were also detected within the hospital ( high-risk vs low-risk areas , P = . 048 ). Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcusfaecalis were only isolated from hospital mobile phones ( P < . 001 and P = . 038 , respectively ). Simmonds ( 2020 ) found that traditional culture-dependent swabbing methods do not provide an accurate picture of contamination and adds , “ Metabarcoding reinforces the need for mobile phone infection control practices to mitigate the risks associated with the increase use of smart device technology in clinical environments . These devices are currently exposing immunocompromised patients to unknown levels of pathogenic and multidrug-resistant bacteria . Departmental differences may suggest that the mobile phone is not just an extension to its owners but to their environment and that routine decontamination should be required to prevent the undermining of hand hygiene and the transmission of pathogenic bacteria .”
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Studies have shown that patients colonized with highly resistant microorganisms ( HRMOs ) contaminate the hospital