دانلود رایگان مقاله انگلیسی آلودگی الکترودهای الکتروانسفالوگرافی قابل استفاده مجدد: مطالعه چند مرکزی - الزویر 2018

Background: Reusable electroencephalography cup electrodes and lead wires (rEEGs-CELWs) could be a source of microorganisms capable of causing hospital-acquired infections. The purpose of this study was to investigate for bacterial species of cleaned rEEGs-CELWs. Methods: This microbiologic evaluation involved 4 epilepsy monitoring units where rEEGs-CELWs were swabbed for bacteria using standard techniques. Analyses involved descriptive statistics and logistic regression (across sites). Results: Of 124 swabs, 31 (25.0%; range, 13.3%-43.3%) showed positive bacterial cultures, without betweensite differences (P = .17). Bacteria were labeled by risk for hospital-acquired infection: no risk, potential risk (primarily in immunocompromised patients), and at risk (associated with infections and antibiotic resistance). At-risk bacteria species were Staphylococcus epidermidis (38.7%), Staphylococcus capitis subsp ureolyticus (3.2%), and Staphylococcus haemolyticus (9.6%). Potential-risk species were Micrococcus spp (22.6%), Acinetobacter lwoffii (6.5%), Staphylococcus hominis subsp hominis (6.5%), and Staphylococcus warneri (6.5%). Bacillus (9.6%) was the only no-risk species. Of 18 antibiotics tested on positive cultures, resistant bacteria were found in a median of 1 (range, 0-11) positive culture, equating to a 6.7% (range, 0%-61.1%) resistant antibiotic rate; no microorganisms were resistant to all antibiotics tested. Conclusions: Bacteria that were potential risk or at risk for infection were found on 22.6% of cleaned rEEGsCELWs. Use of single-use electrodes and research on scalp infection and infection reduction interventions are warranted.

DISCUSSION

Bacteria were found on 25% of clean, reusable EEG electrodes in 4 epilepsy monitoring units. Of 8 bacterial species, 7 (88%) were potential risk or at risk for causing human infection. No white blood cells were found on clean, reusable EEG cup electrodes, but epithelial cell prevalence varied significantly, with lower rates at site A compared with the other 3 sites.

Presence of bacteria and epithelial cells but no white blood cells provided evidence that cleaning procedures at the 4 sites were sufficient to remove evidence of blood, but inadequate in ensuring optimally clean electrodes. Because, to our knowledge, this is the first examination of the presence of epithelial and blood cells on clean EEG electrodes, replication of this research at different sites would provide definitive evidence that cleaning procedures could lead to varying epithelial cell prevalence.

The prevalence of bacterial growth on clean, reusable EEG electrodes was not surprising because other investigators have found bacterial growth on inanimate objects used in hospital and health care environments.4-7 However, EEG electrodes are semi-critical devices that are placed on abraded skin and should not harbor bacteria that can lead to infection and, worse, be antibiotic resistant.