Adaptive Equipment Utilized in Rehabilitation as a Potential Source of Bacterial Contamination

Research Objectives: To investigate the survival time of three clinically important species of bacteria, Bacillus cereus (BC), Escherichia coli (EC), and Staphylococcus aureus (SA), on multi-use rehabilitation equipment.

Design: Known quantities of EC, BC, or SA were uniformly applied to predetermined areas on rehabilitation tools in triplicate. Survival of the bacteria was determined over time course experiments, 30 min to 48 hours. At appropriate times viable cells were removed from the instruments using sterile transport swabs. These swabs were transferred to sterile saline and vortex mixed for 45 seconds. After mixing the saline was diluted and plated to tryptic soy agar, incubated (48 hour @ 37 C), with colonies counted after incubation.

Setting: In-patient and ambulatory health care facilities

Participants: Two rehabilitation instruments were studied, sock aids and patient reachers.

Interventions: Inoculation of equipment with known quantities of three types of commonly encountered bacteria.

Main Outcome Measures: Percent survival for the bacterial species over 48 hours was determined for each species for each instrument.

Results: Two of the bacterial species, BC and SA survived in high quantities at 48 hours, on both rehabilitation instruments, while EC had little survival (2% maximum). Bacterial survival at 48 hours for the sock reacher indicated that 54% of SA, and 17% of BC were still viable. For the reacher "handle" survival was 36% for SA, and 44% for BC. For the reacher "teeth" survival was: 7% for SA and 26% for BC.

Conclusions: Survival of BC and SA on these instruments can be up to several days and may have the potential to cross contaminate patients if shared. If the strain of SA is methicillin resistant then cross contamination of patients via these instruments could cause infections that are difficult to treat. The results obtained for BC, a spore-forming bacterium suggests that survival of this species could be via spores. Patients with open wounds and those that are immunocompromised or immunosuppressed are especially vulnerable to these pathogens. Based on these results, careful cleaning/disinfection of these rehabilitation instruments is recommended.

Author(s) Disclosures: None.