Literature DB >> 19608822

Nosocomial contamination of laryngoscope handles: challenging current guidelines.

Tyler R Call1, Frederic J Auerbach, Scott W Riddell, Deanna L Kiska, Sumena C Thongrod, See Wan Tham, Nancy A Nussmeier.   

Abstract

BACKGROUND: Laryngoscope blades are often cleaned between cases according to well-defined protocols. However, despite evidence that laryngoscope handles could be a source of nosocomial infection, neither our institution nor the American Society of Anesthesiologists has any specific guidelines for handle disinfection. We hypothesized that laryngoscope handles may be sufficiently contaminated with bacteria and viruses to justify the implementation of new handle-cleaning protocols.
METHODS: Sixty laryngoscope handles from the adult operating rooms were sampled with premoistened sterile swabs. Collection was performed between cases, in operating rooms hosting a broad variety of subspecialty procedures, after the room and equipment had been thoroughly cleaned for the subsequent case. Samples from 40 handles were sent for aerobic bacterial culture, and antimicrobial susceptibility testing was performed for significant isolates. Samples from 20 handles were examined for viral contamination using a polymerase chain reaction assay that detects 17 respiratory viruses.
RESULTS: Of the 40 samples sent for culture, 30 (75%) were positive for bacterial contamination. Of these positive cultures, 25 (62.5%) yielded coagulase-negative staphylococci, seven (17.5%) Bacillusspp. not anthracis, three (7.5%) alpha-hemolytic Streptococcusspp., and one each (2.5%) of Enterococcusspp., Staphylococcus aureus(S. aureus), and Corynebacteriumspp. No vancomycin-resistant enterococci, methicillin-resistant S. aureus, or Gram-negative rods were detected. All viral tests were negative.
CONCLUSION: We found a high incidence of bacterial contamination of laryngoscope handles despite low-level disinfection. However, no vancomycin-resistant enterococci, methicillin-resistant S. aureus, Gram-negative rods, or respiratory viruses were detected. Our results support adoption of guidelines that include, at a minimum, mandatory low-level disinfection of laryngoscope handles after each patient use.

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Year:  2009        PMID: 19608822      PMCID: PMC4006105          DOI: 10.1213/ane.0b013e3181ac1080

Source DB:  PubMed          Journal:  Anesth Analg        ISSN: 0003-2999            Impact factor:   5.108


  12 in total

1.  Decontamination of laryngoscopes: a survey of national practice.

Authors:  M D Esler; L C Baines; D J Wilkinson; R M Langford
Journal:  Anaesthesia       Date:  1999-06       Impact factor: 6.955

2.  Contamination of laryngoscopes.

Authors:  M S Ballin; A McCluskey; S Maxwell; S Spilsbury
Journal:  Anaesthesia       Date:  1999-11       Impact factor: 6.955

3.  Serratia marcescens outbreak in a neonatal intensive care unit prompting review of decontamination of laryngoscopes.

Authors:  M M Cullen; A Trail; M Robinson; M Keaney; P R Chadwick
Journal:  J Hosp Infect       Date:  2005-01       Impact factor: 3.926

Review 4.  Recommendations to resolve inconsistent guidelines for the reprocessing of sheathed and unsheathed rigid laryngoscopes.

Authors:  Lawrence F Muscarella
Journal:  Infect Control Hosp Epidemiol       Date:  2007-03-09       Impact factor: 3.254

5.  Transmission of pathogenic bacterial organisms in the anesthesia work area.

Authors:  Randy W Loftus; Matthew D Koff; Corey C Burchman; Joseph D Schwartzman; Valerie Thorum; Megan E Read; Tammara A Wood; Michael L Beach
Journal:  Anesthesiology       Date:  2008-09       Impact factor: 7.892

6.  The neonatal laryngoscope as a potential source of cross-infection.

Authors:  T J Neal; C R Hughes; M M Rothburn; N J Shaw
Journal:  J Hosp Infect       Date:  1995-08       Impact factor: 3.926

7.  The laryngoscope as a potential source of cross-infection.

Authors:  J E Foweraker
Journal:  J Hosp Infect       Date:  1995-04       Impact factor: 3.926

8.  A survey of laryngoscope contamination at a university and a community hospital.

Authors:  R C Morell; D Ririe; R L James; D A Crews; K Huffstetler
Journal:  Anesthesiology       Date:  1994-04       Impact factor: 7.892

9.  Incidence of visible and occult blood on laryngoscope blades and handles.

Authors:  R A Phillips; W P Monaghan
Journal:  AANA J       Date:  1997-06

10.  Laryngoscope handles: a potential for infection.

Authors:  S A Simmons
Journal:  AANA J       Date:  2000-06
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  11 in total

1.  Efficacy of soaking in 70% isopropyl alcohol on aerobic bacterial decontamination of surgical instruments and gloves for serial mouse laparotomies.

Authors:  Jessica N Keen; MaryKay Austin; Li-Shan Huang; Susan Messing; Jeffrey D Wyatt
Journal:  J Am Assoc Lab Anim Sci       Date:  2010-11       Impact factor: 1.232

2.  Hand hygiene compliance monitoring in anaesthetics: Feasibility and validity.

Authors:  A Jeanes; J Dick; P Coen; N Drey; D J Gould
Journal:  J Infect Prev       Date:  2018-02-16

3.  Simple Green Changes for Anesthesia Practices to Make a Difference.

Authors:  Cindy B Yeoh; Kathleen J Lee; Vanja Coric; Luis E Tollinche
Journal:  EC Clin Med Case Rep       Date:  2020-11-16

Review 4.  Principles of infection prevention and reprocessing in ENT endoscopy.

Authors:  Axel Kramer; Wolfgang Kohnen; Susanne Israel; Sylvia Ryll; Nils-Olaf Hübner; Horst Luckhaupt; Werner Hosemann
Journal:  GMS Curr Top Otorhinolaryngol Head Neck Surg       Date:  2015-12-22

5.  Comparison of efficacy and cost-effectiveness of 0.55% ortho-phthalaldehyde and 2% glutaraldehyde for disinfection of laryngoscopes: A prospective pilot study.

Authors:  Priyanka Pradeep Karnik; Nandini Malay Dave; Gita Nataraj; Rajarshi Gupta; Madhu Garasia
Journal:  Indian J Anaesth       Date:  2017-06

6.  Bacterial Contamination and Disinfection Status of Laryngoscopes Stored in Emergency Crash Carts.

Authors:  Jae Hyung Choi; Young Soon Cho; Jung Won Lee; Hee Bong Shin; In Kyung Lee
Journal:  J Prev Med Public Health       Date:  2017

7.  Disinfection of laryngoscopes: A survey of practice.

Authors:  Vaishali Prabhakar Chaskar; Nandini Malay Dave; Raylene Dias; Priyanka Karnik
Journal:  Indian J Anaesth       Date:  2017-03

Review 8.  Cleaning and sterilisation of anaesthetic equipment.

Authors:  Chitra Sanjeev Juwarkar
Journal:  Indian J Anaesth       Date:  2013-09

9.  Laryngoscope decontamination techniques: A survey.

Authors:  Rajiv Chawla; Akhilesh Gupta; Anshu Gupta; Mritunjay Kumar
Journal:  J Anaesthesiol Clin Pharmacol       Date:  2016 Jan-Mar

10.  Pattern of anaesthetic equipment contamination and infection prevention in anaesthesia practice at university hospitals.

Authors:  Rehab M Elsaid Tash; Ahmed A Wegdan; Fatma A Amer; Rasha H A Bassyouni; Joseph M Botros
Journal:  Indian J Anaesth       Date:  2018-10
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