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Bacteriological Monitoring and Evaluation of Cleaning-disinfection of Computer-related Equipment in an Obstetric and Gynecology Hospital

It is already known that computer keyboards and mouses in hospitals are contaminated with different kinds of bacteria. However, the mouse pad has been neglected with regard to both research and regular cleaning and disinfection in hospitals. In our study, we monitored and evaluated the bacteriology degrees of 74 computers’ keyboards, mouses and mouse pads from six departments. The results showed that before cleaning-disinfection, the contamination rate of the mouse pad ranked second following the keyboards. Enterococcus Faecium was cultured from the mouse pads. The computer-related equipment in the wards and outpatient rooms were much more contaminated than that in the operating rooms. Acinetobacter spp. was only isolated from the doctor’s computers. After cleaning-disinfection, 4 strains of MRSA were isolated from the keyboards and the mouses, one and 3 were cultured at day 3 and day 5 after cleaning-disinfection, respectively. One strain of Pseudomonas Aeruginosa was isolated from the mouses at day 3 after cleaning-disinfection. These demonstrated that the bacterial contamination of the mouse pads must be as emphasized as that of the keyboards and mouses. Furthermore, It is better to clean and disinfect the computer-related equipment(keyboards, mouses, mouse pads) at least once a day.


39
On a global scale, hospital-acquired infections (HAIs) have become one of the most 40 important causes of morbidity and mortality in medical institutions [1][2][3][4][5] and also threaten 41 the safety of health-care providers [6]. According to a survey from the World Health 42 Organization, there are approximately 1.7 million and 4.5 million HAI patients in USA and 43 Europe, respectively, accounting for 37,000 and 100,000 deaths each year. Many pathogens, 44 such as MRSA, VRE, Acinetobacter, Klebsiella, Listeria, Escherichia coli, Mycobacterium 45 tuberculosis, Pseudomonas aeruginosa and the Noel virus, can survive on a dry object 46 surface for several months or even a year [7-9]. Therefore, cleaning and disinfecting the 47 high-touch object surfaces is an important measure for controlling HAIs [10]. 48 There have been many studies emphasizing the importance of cleaning and disinfecting 49 the computer keyboard and mouse in healthcare settings, representing an important type of 50 high-touch object surface. One study demonstrated that 95% of keyboards in a teaching 51 hospital had growth of one or more microorganisms, and 5% were positive for pathogens 52 known to be associated with HAI transmission, such as Staphylococcus aureus and 53 Enterococci [11]. Some studies showed that the keyboard or mouse was one of the most 54 likely bacterial vehicles in the ICU and that the degree of contamination cannot be 55 neglected [12][13][14]. A survey of two acute district general hospitals indicated that MRSA 56 had been identified on computer terminals (24%), and five of the MRSA-positive terminals 57 were from hospital A, which had a significantly higher rate of MRSA transmission than  Table 1). In the 69 wards, 1 nurse's station computer, 1 doctor's office computer and 1 doctor's mobile 70 computer from each obstetric and gynecology ward were selected randomly for testing. 71 Five samples were collected from every surface, including before cleaning-disinfection, 72 immediately after cleaning-disinfection and day 1, day 3 and day 5 after  , in which R was the number of sample rates that had to be compared in pairs. The contamination rate (%) was the proportion of samples with bacterial colonies 94 >10 cfu/cm 2 . 95 96

97
Bacteriological Analysis before Cleaning-disinfection 98 The bacterial contamination of keyboards, mouses and mouse pads 99 As shown in Table 1, there were significant differences in the contamination rate 100 between the keyboard group and the mouse group, as well as between the mouse group and 101 mouse pad group, from high to low was keyboards, mouse pads and mice, respectively. The 102 potentially pathogenic bacteria cultured from the computer-related equipment was as 103 shown in Supplementary were cultured from the wards. Enterococcus Faecium was from the neonatal dept.

121
Klebsiella. Pneumoniae was isolated from the operating rooms (Supplementary Table 3).
122   Table 3). The species of potentially pathogenic 133 bacteria from the doctor's computers was more than that from the nurse's computers, 134 Acinetobacter lwoffii and Acinetobacter ursingii were isolated from the doctor's computers. 135 One strain of Enterobacter cloacae was from the nurse's computers in the gynecology 136 wards, 2 isolated of Pseudomonas were cultured from the obstetric wards (Supplementary   137   Table 4-5).
138 Table 3 The contamination rate of computer-related equipment in obstetric and gynecology wards before  Table 6).
154 Table 4 The contamination rate of computer-related equipment after cleaning-disinfection. the results were as same as in our study [20]. The mouse pads have been relatively 166 disregarded in the medical settings. Furthermore, the contamination rates of 167 computer-related equipment in the wards and outpatient rooms were significantly higher 168 than that in the operating rooms. In the gynecology wards, the contamination rate of the 169 doctor's computer-related equipment was higher than that of nurse's computer-related 170 equipment. 171 The most common bacteria cultured from the computer-related equipment was 172 "patient-object-patient" pathogens transmission, hand carriage plays an important role.