Computer Keyboards: A Reservoir for Nosocomial Pathogens
Abstract & Commentary
Synopsis: Of 100 keyboards in 29 clinical areas tested for bacterial contamination, 95% were positive for microorganisms, including one with vancomycin-resistant Enterococcus.
Source: Schultz M, et al. Bacterial contamination of computer keyboards in a teaching hospital. Infect Control Hosp Epidemiol. 2003;24:302-303.
This study was conducted in a 167-bed veterans Affairs Medical Center to identify potential sources of drug-resistant organisms. In that institution, 2000 desktop computers were in use throughout the medical center, including inpatient units, ICUs, the operating room, and ambulatory care center. In addition, laptop computers were transported to the bedside by nurses and physicians to enter orders, progress notes, and vital signs. During a 4-week period, 100 specimens were collected from computer keyboards in high-use patient care areas. Of 100 cultures, 95% had growth of one or more microorganisms. The majority of the cultures were positive for skin organisms. These included 84 keyboards with Staphylococcus, 44 with Bacillus species, and 8 with Corynebacterium species. In addition, 9 keyboards were positive for Streptococcus, 6 for Gram-negative rods, 4 for Clostridium perfringens, 4 for enterococci, including one for vancomycin-resistant Enterococcus, and 2 for Pseudomonas. Three of the negative cultures were from the operating room and the remaining 2 were from patient care areas.
Comment by Leslie A. Hoffman, PhD, RN
During the past decade, a number of studies have examined the hospital environment as a potential source of bacterial contamination and risk for infection. In this medical center, the overwhelming majority of cultures obtained from computer keyboards grew microorganisms. Although most keyboards were contaminated with skin flora, a minority grew Staphylococcus aureus, enterococci, Gram-negative rods, and other organisms known to be potential pathogens.
The common practice of data entry before, during, and after patient rounds creates the possibility of transmitting microorganisms from one patient to another. Whether this actually occurs or how often is unknown. Several prior studies have also found computer keyboards to be contaminated with microorganisms. In one study conducted in a medical intensive care unit (MICU), contamination of computer keyboards (24% of samples) was higher than that for faucets (11%). Using pulsed-field gel electrophoresis, Bures and colleagues documented an indistinguishable methicillin-resistant S aureus strain in 2 patients, the computer keyboards and faucets in each of their rooms, and several other keyboards throughout the MICU.1
A second study traced bacterial contamination to a practice wherein gloved patient care staff moved back and forth between the patient and the keyboard and ungloved support staff, who never touched the patient, entered the room and retrieved data from the same computer.2 In the present study, no specific method or group was assigned to clean computer keyboards on a routine basis and plastic keyboard covers were not in use. Findings of the present study provide further support that computer keyboards, as well as other environmental surfaces, can serve as a source for nosocomial infection. Given this, the use of keyboard covers and adherence to routine cleaning practices would seem essential.
Dr. Hoffman is Professor Medical-Surgical Nursing Chair, Department of Acute/Tertiary Care University of Pittsburgh School of Nursing.
References
1. Bures S, et al. Computer keyboards and faucet handles as reservoirs of nosocomial pathogens in the intensive care unit. Am J Infect Control. 2000;28:465-471.
2. Neely AN, et al. Computer keyboards as reservoirs for Acinetobacter baumannii in a burn hospital. Clin Infect Dis. 1999;29:1358-1359.
Of 100 keyboards in 29 clinical areas tested for bacterial contamination, 95% were positive for microorganisms, including one with vancomycin-resistant Enterococcus.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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