TY - JOUR
T1 - Relationship between shared patient care items and healthcare-associated infections
T2 - A systematic review
AU - Livshiz-Riven, Ilana
AU - Borer, Abraham
AU - Nativ, Ronit
AU - Eskira, Seada
AU - Larson, Elaine
N1 - Publisher Copyright:
© 2014 Elsevier Ltd.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background: Environmental surfaces may contribute to transmission of nosocomial pathogens. Noninvasive portable clinical items potentially shared among patients (NPIs) are part of the patient's immediate surroundings and may pose a threat of pathogen transmission. Objective: To assess the body of literature describing the range of microorganisms found on NPIs and evaluate the evidence regarding the potential for cross-transmission of microorganisms between NPIs and hospitalized patients in non-outbreak conditions. Design: A comprehensive list of NPIs was developed, and a systematic review of these items combined with healthcare-associated infection related keywords was performed. Data sources: PubMed, Scopus, and Cochrane Library. Review methods: A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to identify and synthesize research reports published between January 1990 and July 2013 on studies regarding contamination of NPIs and association to infections in non-outbreak circumstances. Results: 1498 records were scanned for eligibility. Thirteen studies met inclusion criteria. Overall, rates of NPI contamination ranged from 23% to 100%. Normal skin or environmental flora were found on almost all positive cultures. Potential pathogens, e.g., Staphylococcus aureus, were present on up to 86%, and Pseudomonas spp. and/or Enterobacteriaceae in 38% of positive cultures. Multi-drug resistant organisms were isolated from up to 25% of items. Three studies explored association between NPIs contamination and patient colonization and infection. One study reported 5 patients with healthcare-associated infections with pathogens found concurrently on NPIs, one found cross-transmission between patient skin bacteria and NPI contamination, and a third did not find any cross-transmission. Conclusions: Potential pathogens and multiply resistant organisms present on NPIs in routine, non-outbreak conditions and in a variety of settings confirms the need to improve NPIs decontamination practices.
AB - Background: Environmental surfaces may contribute to transmission of nosocomial pathogens. Noninvasive portable clinical items potentially shared among patients (NPIs) are part of the patient's immediate surroundings and may pose a threat of pathogen transmission. Objective: To assess the body of literature describing the range of microorganisms found on NPIs and evaluate the evidence regarding the potential for cross-transmission of microorganisms between NPIs and hospitalized patients in non-outbreak conditions. Design: A comprehensive list of NPIs was developed, and a systematic review of these items combined with healthcare-associated infection related keywords was performed. Data sources: PubMed, Scopus, and Cochrane Library. Review methods: A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to identify and synthesize research reports published between January 1990 and July 2013 on studies regarding contamination of NPIs and association to infections in non-outbreak circumstances. Results: 1498 records were scanned for eligibility. Thirteen studies met inclusion criteria. Overall, rates of NPI contamination ranged from 23% to 100%. Normal skin or environmental flora were found on almost all positive cultures. Potential pathogens, e.g., Staphylococcus aureus, were present on up to 86%, and Pseudomonas spp. and/or Enterobacteriaceae in 38% of positive cultures. Multi-drug resistant organisms were isolated from up to 25% of items. Three studies explored association between NPIs contamination and patient colonization and infection. One study reported 5 patients with healthcare-associated infections with pathogens found concurrently on NPIs, one found cross-transmission between patient skin bacteria and NPI contamination, and a third did not find any cross-transmission. Conclusions: Potential pathogens and multiply resistant organisms present on NPIs in routine, non-outbreak conditions and in a variety of settings confirms the need to improve NPIs decontamination practices.
KW - Colonization
KW - Contamination
KW - Cross-infection
KW - Equipment and supplies
KW - Hospital
KW - Non-critical items
UR - http://www.scopus.com/inward/record.url?scp=84919492717&partnerID=8YFLogxK
U2 - 10.1016/j.ijnurstu.2014.06.001
DO - 10.1016/j.ijnurstu.2014.06.001
M3 - Review article
C2 - 24997681
AN - SCOPUS:84919492717
SN - 0020-7489
VL - 52
SP - 380
EP - 392
JO - International Journal of Nursing Studies
JF - International Journal of Nursing Studies
IS - 1
ER -