Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-23T04:09:06.161Z Has data issue: false hasContentIssue false

Blood Pressure Cuff as a Potential Vector of Pathogenic Microorganisms A Prospective Study in a Teaching Hospital

Published online by Cambridge University Press:  21 June 2016

C. de Gialluly*
Affiliation:
Laboratory of Microbiology and Hospital Hygiene, University Hospital, Tours, France
V. Morange
Affiliation:
Laboratory of Microbiology and Hospital Hygiene, University Hospital, Tours, France
E. de Gialluly
Affiliation:
Laboratory of Microbiology and Hospital Hygiene, University Hospital, Tours, France
J. Loulergue
Affiliation:
Laboratory of Microbiology and Hospital Hygiene, University Hospital, Tours, France
N. van der Mee
Affiliation:
Laboratory of Microbiology and Hospital Hygiene, University Hospital, Tours, France
R. Quentin
Affiliation:
Laboratory of Microbiology and Hospital Hygiene, University Hospital, Tours, France
*
Laboratoire de Bactériologie et d'Hygiène Hospitalière, Hôital Trousseau, 37044 Tours cedex 1, France, ([email protected])

Abstract

Objective.

To investigate the potential role of blood pressure (BP) cuffs in the spread of bacterial infections in hospitals.

Design.

A comprehensive, prospective study quantitatively and qualitatively evaluating the bacterial contamination on BP cuffs of 203 sphygmomanometers in use in 18 hospital units from January through March 2003.

Setting.

A university hospital with surgical, medical, and pediatric units.

Results.

A level of contamination reaching 100 or more colony-forming units per 25 cm2 was observed on 92 (45%) of inner sides and 46 (23%) of outer sides of 203 cuffs. The highest rates of contamination occurred on the inner side of BP cuffs kept in intensive care units (ICUs) (20 [83%] of 24) or on nurses' trolleys (27 [77%] of 35). None of the 18 BP cuffs presumed to be clean (ie, those that had not been used since the last decontamination procedure) had a high level of contamination. Potentially pathogenic microorganisms were isolated from 27 (13%) of the 203 BP cuffs: 20 of these microorganisms were Staphylococcus aureus, including 9 methicillin-resistant strains. The highest rates of contamination with potentially pathogenic microorganisms were observed on cuffs used in ICUs and those kept on nurses' trolleys. For 4 patients with a personal sphygmomanometer, a genetic link was found between the strains isolated from the BP cuffs and the strains isolated from the patients.

Conclusions.

The results of this survey highlight the importance of recognizing BP cuffs as potential vectors of pathogenic bacteria among patients and as a source of reinfection when dedicated to a single patient, emphasizing the urgent need for validated procedures for their use and maintenance.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Tikhomirov, E. WHO programme for the control of hospital infections. Chemioterapia 1987; 6:148151.Google Scholar
2.French Prevalence Survey Study Group. Prevalence of nosocomial infections in France: results of the nationwide survey in 1996. J Hosp Infect 2000; 46:186193.Google Scholar
3.Jarvis, WR. Infection control and changing health-care delivery systems. Emerg Infect Dis 2001; 7:170173.CrossRefGoogle ScholarPubMed
4.Weinstein, RA. Nosocomial infection update. Emerg Infect Dis 1998; 4:416420.Google Scholar
5.Gerken, A, Cavanagh, S, Winner, HI. Infection hazard from stethoscopes in hospital. Lancet 1972; 1:1214.Google Scholar
6.Marinella, MA, Pierson, C, Chenoweth, C. The stethoscope: a potential source of nosocomial infection. Arch Intern Med 1997; 157:786790.Google Scholar
7.Wong, D, Nye, K, Hollis, P. Microbial flora on doctors' white coats. BMJ 1991; 303:16021604.Google Scholar
8.Embil, JM, Zhanel, GG, Plourde, PJ, Hoban, D. Scissors: a potential source of nosocomial infection. Infect Control Hosp Epidemiol 2002; 23:147151.Google Scholar
9.Beard, MA, McIntyre, A, Rountree, PM. Sphygmomanometers as a reservoir of pathogenic bacteria. Med J Aust 1969; 2:758760.CrossRefGoogle ScholarPubMed
10.Myers, MG. Longitudinal evaluation of neonatal infection: association of infection with a blood pressure cuff. Pediatrics 1978; 61:4245.Google Scholar
11.Layton, MC, Perez, M, Heald, P, Patterson, JE. An outbreak of mupirocin-resistant Staphylococcus aureus on a dermatology ward associated with an environmental reservoir. Infect Control Hosp Epidemiol 1993; 14:369375.Google Scholar
12.Manian, FA, Meyer, L, Jenne, J. Clostridium difficile contamination of BP cuffs: a call for a closer look at gloving practices in the era of universal precautions. Infect Control Hosp Epidemiol 1996; 17:180182.Google Scholar
13.Bonten, MJM, Hayden, MK, Nathan, C, et al. Epidemiology of colonization of patients and environment with vancomycin-resistant enterococci. Lancet 1996; 348:16151619.Google Scholar
14.Base-Smith, V. Nondisposable sphygmomanometer cuffs harbour frequent bacterial colonization and significant contamination by organic and inorganic matter. AANA J 1996; 64:141145.Google Scholar
15.Cormican, MGM, Lowe, DJ, Keane, P, Flynn, J, O'Toole, K. The microbial flora of in-use BP cuffs. Ir J Med Sci 1991; 160:112113.Google Scholar
16.Sternlicht, AL, Poznak, AV. Significant bacterial colonization occurs on the surface of non-disposable sphygmomanometer cuffs and re-used disposable cuffs [abstract]. Anesth Analg 1990; 70(Suppl):S391.Google Scholar
17.Osawa, K, Nakajima, M, Kataoka, N, Arakawa, S, Kamidono, S. Evaluation of antibacterial efficacy of drugs for urinary tract infections by genotyping based on pulsed-field gel electrophoresis (PFGE). J Infect Chemother 2002;8:353357.Google Scholar
18.Deplano, A, Witte, W, Van Leeuwen, WJ, Brun, Y, Struelens, MJ. Clonal dissemination of epidemic methicillin-resistant Staphylococcus aureus in Belgium and neighboring countries. Clin Microbiol Infect 2000; 6:239245.Google Scholar
19.Mereghetti, L, Marquet-van der Mee, N, Loulergue, J, Audurier, A. Pseudomonas aeruginosa from cystic fibrosis patients: study using whole cell RAPD and antibiotic susceptibility. Pathol Biol 1998; 46:319324.Google Scholar