TY - JOUR
T1 - Risk factors of cardiac device infection
T2 - Glove contamination during device procedures
AU - Kozon, Isabella
AU - Riahi, Sam
AU - Lundbye-Christensen, Søren
AU - Thøgersen, Anna Margrethe
AU - Ejlertsen, Tove
AU - Aaen, Dorthe
AU - Paulsen, Kirsten I
AU - Hjortshøj, Søren
N1 - Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Infections in cardiac implantable electronic devices (CIEDs) constitute a serious complication. We sought to identify contamination of gloves before handling the device in primary and replacement CIED procedures.METHODS: Two groups of 30 patients underwent primary CIED implantation or replacement. Before the device entered the surgical field, surgeon and assistant imprinted their outer gloves on aerobe and anaerobe agar plates, and a wound swab was performed. Samples were cultured, and the presence of bacteria was identified, counted as the number of colony forming units, and characterized to the level of genus and species.RESULTS: Samples from 40 (67%) procedures revealed bacteria on surgeons' or assistants' gloves. Contamination occurred in 80% of replacements and 67% of primary implantations (risk difference, 13%; 95% confidence interval [CI], -8.8 to 35.5). Contamination of surgeons' and assistants' gloves occurred in 55% and 44% of procedures, respectively. Coagulase-negative Staphylococcus (CNS) occurred in 52%, and Propionibacterium spp (PS) occurred in 84% of positive cases. For every 15 minutes of procedure time, colony levels increased by 7.4% (95% CI, 1.4%-13.4%).CONCLUSIONS: Contamination of gloves is common during CIED procedures before handling the device. Therefore, devices are often handled with contaminated gloves. The most prevalent bacteria were PS and CNS, which are associated with clinical CIED infections. Changing outer gloves before handling the device might improve sterile state and lower infection risk.
AB - BACKGROUND: Infections in cardiac implantable electronic devices (CIEDs) constitute a serious complication. We sought to identify contamination of gloves before handling the device in primary and replacement CIED procedures.METHODS: Two groups of 30 patients underwent primary CIED implantation or replacement. Before the device entered the surgical field, surgeon and assistant imprinted their outer gloves on aerobe and anaerobe agar plates, and a wound swab was performed. Samples were cultured, and the presence of bacteria was identified, counted as the number of colony forming units, and characterized to the level of genus and species.RESULTS: Samples from 40 (67%) procedures revealed bacteria on surgeons' or assistants' gloves. Contamination occurred in 80% of replacements and 67% of primary implantations (risk difference, 13%; 95% confidence interval [CI], -8.8 to 35.5). Contamination of surgeons' and assistants' gloves occurred in 55% and 44% of procedures, respectively. Coagulase-negative Staphylococcus (CNS) occurred in 52%, and Propionibacterium spp (PS) occurred in 84% of positive cases. For every 15 minutes of procedure time, colony levels increased by 7.4% (95% CI, 1.4%-13.4%).CONCLUSIONS: Contamination of gloves is common during CIED procedures before handling the device. Therefore, devices are often handled with contaminated gloves. The most prevalent bacteria were PS and CNS, which are associated with clinical CIED infections. Changing outer gloves before handling the device might improve sterile state and lower infection risk.
KW - Journal Article
U2 - 10.1016/j.ajic.2017.03.019
DO - 10.1016/j.ajic.2017.03.019
M3 - Journal article
C2 - 28526307
SN - 0196-6553
VL - 45
SP - 866
EP - 871
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 8
ER -