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Open Access Highly Accessed Research article

Poorly processed reusable surface disinfection tissue dispensers may be a source of infection

Günter Kampf12*, Stina Degenhardt3, Sibylle Lackner3, Katrin Jesse3, Heike von Baum4 and Christiane Ostermeyer3

Author Affiliations

1 BODE SCIENCE CENTER, Bode Chemie GmbH, Melanchthonstr. 27, 22525 Hamburg, Germany

2 Institut für Hygiene und Umweltmedizin, Ernst-Moritz-Arndt Universität Greifswald, Walther-Rathenau-Str. 49a, 17475 Greifswald, Germany

3 Microbiology, Bode Chemie GmbH, Melanchthonstr. 27, 22525 Hamburg, Germany

4 Department for Medical Microbiology and Hygiene, University Hospital Ulm, Albert-Einstein-Allee 23, 89091 Ulm, Germany

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BMC Infectious Diseases 2014, 14:37  doi:10.1186/1471-2334-14-37

Published: 21 January 2014

Abstract

Background

Reusable surface disinfectant tissue dispensers are used in hospitals in many countries because they allow immediate access to pre-soaked tissues for targeted surface decontamination. On the other hand disinfectant solutions with some active ingredients may get contaminated and cause outbreaks. We determined the frequency of contaminated surface disinfectant solutions in reusable dispensers and the ability of isolates to multiply in different formulations.

Methods

Reusable tissue dispensers with different surface disinfectants were randomly collected from healthcare facilities. Solutions were investigated for bacterial contamination. The efficacy of two surface disinfectants was determined in suspension tests against two isolated species directly from a contaminated solution or after 5 passages without selection pressure in triplicate. Freshly prepared use solutions were contaminated to determine survival of isolates.

Results

66 dispensers containing disinfectant solutions with surface-active ingredients were collected in 15 healthcare facilities. 28 dispensers from nine healthcare facilities were contaminated with approximately 107 cells per mL of Achromobacter species 3 (9 hospitals), Achromobacter xylosoxidans or Serratia marcescens (1 hospital each). In none of the hospitals dispenser processing had been adequately performed. Isolates regained susceptibility to the disinfectants after five passages without selection pressure but were still able to multiply in different formulations from different manufacturers at room temperature within 7 days.

Conclusions

Neglecting adequate processing of surface disinfectant dispensers has contributed to frequent and heavy contamination of use-solutions based on surface active ingredients. Tissue dispenser processing should be taken seriously in clinical practice.

Keywords:
Surface disinfection; Reusable dispenser; Surface-active biocidal ingredients; Bacterial contamination; Achromobacter spp; Adaptation; Biofilm