Security swipe cards & scanners are potential reservoir for hospital aquired infection

Hibah Abdul- Wahab Abusulaiman

Collage of Applied Medical SciencesLaboratory Medicine

Microbiology DepartmentDecember 3rd, 2011

Who is he?

He invented…Steve Jobs

She invented…?

Who is she?

Ms. Lisa Holmes

I will Keep the Best Part for the End

You will Guess…

In her invention, she considered…

Smartcards, Credit Cards, Identification Cards, Healthcare Cards, Employee Badges, Rewards Cards, Chips, and Tokens and transmission of microbes and pathogens that thrive on there

surfaces.

A study speaks about…

It took the concern of…

The Presentation’s Outline

• The research problem.• The aim of the study.• Methodology.• Results.• Conclusion.• Critique.• Recommendation.• Ms. Lisa’s invention.

The Research Problem

The Aim of the Study

1• To determine if swipe cards and wall- mounted

scanners harbour potentially harmful bacteria

Methodology

• Sample:– Study population:

• 45 doctors working in the departments of: general, orthopaedic and urological surgery at the Queen Elizabith Hospital, Kings Lynn, UK.

• 39 consented and their security swipe cards.

– Scanners:• 16 swipe- cards scanners in that words.

Methodology

1• Questionnaire completion

2• Culturing participant’s swipe cards

3• Determining if swipe-cards scanners harbour bacteria

5• Assessing a single method for cleaning scanners

Methodology

To determine:– Where they kept their swipe card while working.– Frequency of its usage.– Clinical accessed areas through their cards in the past 24 hrs.– Frequency and methods of cleaning their cards.

1• Questionnaire completion:

Methodology

2• Culturing participant’s swipe cards:

Tryptone Soya Agar (TSA)

Aerobically at 36OC

for 24 hrs

at 30OC for 48 hrsIncubated

Methodology

3• Determining if swipe- cards scanners harbour bacteria

Using sterile swipe cards

TSA

Aerobically at 36OC

for 24 hrs

at 30OC for 48 hrsIncubated

Methodology

1. Scrubbing with soap and water for 30 seconds.2. Scrubbing with hibiscrub for 30 seconds.3. Cleaning with an alcohol- soaked swab for 15

seconds.

4• Assessing three methods of cleaning swipe cards:

TSA

Aerobically at 36OC

for 24 hrs

at 30OC for 48 hrs

Incubated

Methodology

5• Assessing a single method for cleaning scanners:

Using sterile swipe cards( drawn x3)

Cleaning

for 15 s

TSA

Aerobically at 36OC

for 24 hrs

at 30OC for 48 hrs

Incubated

MethodologyFollowing incubation:

Antibiotic Sensitivity Testing

(AST)

Detection of: S. aureus, MRSA, Enterococcus spp.,

coliforms and Pseudomonas spp.

Colony Count (CFU)

Results% in

respect to 39 participants Mean

number CFUs

Colonised with pathogenic bacteria:

n (%)

% of colonised with pathogenic bacteria in respect to the 39

participants

7320.5%

And 79.5% were environmental

bacteria

Grade

Consultant (n= 10)

25.64% 59 3 (30% ) 7.69%

Middle- grade (n= 13)

33.33% 92 5 (38% ) 12.82%

House officer (n= 16)

41.02% 68 -- 0%

Specialty

General surgery (n= 23)

58.97% 73 5 (22% ) 12.82%

Orhtopaedics (n= 12)

30.76% 84 2 (17% ) 5.12%

Urology (n= 4)

10.25% 46 1 (25% ) 2.56%

Results

% in respect to 39 participants

Mean number

CFUs

Colonised with pathogenic

bacteria: n (%)

% of colonised with pathogenic bacteria in

respect to the 39 participants

Frequency of use

Frequent (> 15 times/ wk) n= 19

48.71% 52 5 (26% ) 12.82%

Moderate (5- 15 times/ wk) n= 14

35.89% 86 3 (21% ) 7.69%

Occasional (< 5times/ wk) n= 6

15.38% 113 -- 0%

Where card kept

Necklace (n= 11) 28.20% 54 1 (9% ) 2.56%

Belt (n= 13) 33.33% 55 2 (15% ) 5.12%

Pocket (n= 15) 38.46% 108 5 (33% ) 12.82%

Card cleaned

Never (n= 32) 82.05% 83 6 (19% ) 15.38%

Yes (n= 7) 17.94% 29 2 (29% ) 5.12%

Results

• Overall, 8 (20.5%) were contaminated with potentially pathogenic bacteria including S. aureus, Pseudomonas putida and coliforms.

• One of the latter bacteria being resisitant to ampicillin.

Scanners Results

• Bacteria were cultured from 14 of 16 scanners (88%) examined.

• All the bacteria cultured were environmental pathogens.

• There was wide variation in the number of CFUs cultured from different scanners.

• The highest counts being obtained from scanners adjacent to main operating theaters, the day- surgery unit and the administration block.

Card Cleaning Results

• No bacteria were cultured from swipe cards following a 30s wash with hibiscrub or a 15s with an alcohol- soaked swab.

• 31 CFUs were cultured from cards cleaned by washing in soap and water for 30s.

Scanner Cleaning Results

• No bacteria were cultured from scanners following cleaning with alcohol swabs.

Conclusion

• The majority of cards and scanners were contaminated by environmental bacteria with low pathogenic potential.

• Bacteira with significant pathogenic potential, and implicated as causes of nosocomial infection were isolated from 20.5% of swipe cards.

Conclusion

• Two thirds of these 20.5% pathogenic contaminated cards were kept in wallets or pockets.

• Large numbers of bacteria were transferred from card to scanner, and scanner to card during experimental use.

Conclusion

• All contaminated cards were carried by consultants and middle- grade surgeons suggests that duration of use of a card may be of relevance.

• Previous cleaning of swipe cards by owners resulted in a notable, but non-significant, reduction in the number of CFUs isolated.

Conclusion

• Cleaning cards and scanners with alcohol in a controlled fashion effectively removed all bacteria.

Conclusion

• There is no corrolation between colonisation with pathogenic bacteria and any of the other recorded parameters, including how the cards was carried, frequency of use, areas of use and cleaning practice.

Critique

• The aim of the study was fully covered through its methodology.

Methodology Critique

• The three methods of cleaning the swipe cards were not well described.

• In the methodology: the researchers did not justify the fluctuation in incubation temperature.

Results CritiqueResults

Mean number CFUs

Colonised with pathogenic bacteria: n

(%)

% of colonised with pathogenic bacteria in

respect to the 39 participants

Grade

Consultant (n= 10)

59 3 (30% ) 7.69%

Middle- grade (n= 13)

92 5 (38% ) 12.82%

House officer (n= 16)

68 -- 0%

Specialty

General surgery (n= 23)

73 5 (22% ) 12.82%

Orhtopaedics (n= 12)

84 2 (17% ) 5.12%

Urology (n= 4)

46 1 (25% ) 2.56%

Author:

Insignificant

Significant

Results

Mean number CFUs

Colonised with pathogenic bacteria:

n (%)

% of colonised with pathogenic bacteria in

respect to the 39 participants

Frequency of use

Frequent (> 15 times/ wk) n= 19

52 5 (26% ) 12.82%

Moderate (5- 15 times/ wk) n= 14

86 3 (21% ) 7.69%

Occasional (< 5times/ wk) n= 6

113 -- 0%

Where card kept

Necklace (n= 11) 54 1 (9% ) 2.56%

Belt (n= 13) 55 2 (15% ) 5.12%

Pocket (n= 15) 108 5 (33% ) 12.82%

Card cleaned

Never (n= 32) 83 6 (19% ) 15.38%

Ever (n= 7) 29 2 (29% ) 5.12%

Results CritiqueAuthor:

Insignificant Significant

Results Critique

• Authors: “There is no correlation between colonisation with pathogenic bacteria and any of the other recorded parameters, including how the cards was carried, frequency of use, areas of use and

cleaning practice”.

• ↑Usage frequency→ ↓ Hiding card→ ↓Bacteria

Results Critique

• The study did not mention an exact number or percentage of each pathogenic bacteria isolated from cards.

Recommendations

• Always be sure of wearing such cards on a necklace or belt.

• Be aware of cleaning that card and its scanners with alcohol.

So what do you think she invented?

Ms. Lisa Holmes

Ms. Lisa Holmes

Any Questions?!

Hibah A. W. Abu-Sulaiman