Thursday April 10, 2008
Role of chest X-ray machine in the transmission of resistant bacteria in the ICU


See this interesting study from Drs Levin and coll. from Hadassah Hebrew University Hospital, Jerusalem, Israel and presented at 28th International Symposium on Intensive Care and Emergency Medicine, Brussels, Belgium (18–21 March 2008).

METHODS: Compliance with infection control measures was measured covertly during the performance of daily chest X-ray scans. Bacterial surface cultures were taken from the X-ray machines. An educational intervention (informing the technicians about resistant bacteria, machine culture results and correct alcohol and glove use) was instituted. Observations and machine cultures were repeated. The appearance of resistant bacteria in patient cultures was followed.

Results: Infection control practices were compared before and after the intervention.

• Alcohol hand-rub use before patient contact increased from 12% to 25% of occasions, from 0% to 62% prior to touching the X-ray machine and from 9% to 39% before touching the next patient. Glove use also improved significantly.
• Resistant Gram-negative bacteria grew in 12/31 (39%) preintervention X-ray machine cultures and 0/29 postintervention cultures.
• Cultures with no bacterial growth increased from 11/31 (33%) to 22/29 (67%) pre to post intervention.
• New occurrences of resistant Gram-negative bacteria in clinical cultures decreased from 19 in 68 patients (28%) pre intervention to 8/84 (10%) post intervention.

Conclusion: Resistant Gram-negative bacteria are found frequently on the X-ray machine, probably being transferred on technicians' hands. This represents the potential for patient-to-patient bacteria transfer. A simple infection control intervention decreases X-ray machine contamination and is associated with a decrease in the appearance of resistant bacteria in patient cultures, although causality is not proven.



Reference: click to get abstract

A potential role for the chest X-ray in the transmission of resistant bacteria in the ICU, from 28th International Symposium on Intensive Care and Emergency Medicine, Brussels, Belgium, 18-21 March 2008. Critical Care 2008, 12(Suppl 2):P10