A prospective study of bacterial and blood contamination of laryngoscope handles in anaesthetic rooms
Jones, William Ceri
Cardiff Metropolitan University
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The laryngoscope is a type of endoscope used to visualize the larynx and adjacent structures, most commonly for the purpose of inserting a tube into the tracheobronchial tree. The blades and handles of rigid laryngoscopes have been documented to be contaminated with blood, body fluids, and potentially pathogenic microorganisms during clinical use. Despite recommending that laryngoscope blades be routinely sterilized after each individual use, there is no reference at all to laryngoscope handles in Abertawe Bro Morgannwg (ABM) University National Health Service (NHS) Trust's 'Decontamination of Equipment Policy', and as a result it is believed that handles are merely 'wiped-down' with alcohol wipes and allowed to air dry between uses. The purpose of this study was to determine the incidence of bacterial and blood contamination on laryngoscope handles deemed to be 'ready for patient use' in the anaesthetic rooms of two of the major hospitals within ABM University NHS Trust, and determine whether or not the extent and/or nature of any contamination was related to the specific region of the handle from which it was isolated. In order to achieve this, samples were taken from three predefined sites on each handle and (a) cultured for microbial contamination on non-selective agar plates. The extent of any subsequent growth was recorded semi-quantitatively and organisms were identified using a microflex™ LT MALDI-TOF mass spectrometer (Bruker Daltonics); (b) tested for occult blood contamination by means of the guaiac paper slide test using Hema-Screen™ slides (Immunostics, Inc.). 86 % of the laryngoscope handles tested were contaminated with microorganisms, no handles were found to be contaminated with blood. Knurled regions of the handles were found to harbour greater numbers of bacteria and a greater range of species than smooth regions; and the knurled region at the contact point between the tip of the laryngoscope blade and the handle was found to be particularly susceptible to contamination with oropharyngeal flora. Although laryngoscope handles have not been directly linked to HAI the presence of opportunistic pathogens on these fomites suggest their potential as vectors for microbial transmission, and represent an increased risk to the patient.
MSc Biomedical Science
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