title: Computer keyboard and mouse as a reservoir of pathogens in an intensive care unit.
abstract: OBJECTIVE
  User interfaces of patient data management systems (PDMS) in intensive care units (ICU), like computer keyboard and mouse, may serve as reservoirs for the transmission of microorganisms. Pathogens may be transferred via the hands of personnel to the patient causing nosocomial infections. The purpose of this study was to examine the microbial contamination of computer user interfaces with potentially pathogenic microorganisms, compared with other fomites in a surgical intensive care unit of a tertiary teaching hospital.
  
  
  METHODS
  Sterile swab samples were received from patient's bedside computer keyboard and mouse, and three other sites (infusion pumps, ventilator, ward round trolley) in the patient's room in a 14 bed surgical intensive care unit at a university hospital. At the central ward samples from keyboard and mouse of the physician's workstation, and control buttons of the ward's intercom and telephone receiver were obtained. Quantitative and qualitative bacteriological sampling occurred during two periods of three months each on eight nonconsecutive days.
  
  
  RESULTS
  In all 14 patients' rooms we collected a total of 1118 samples: 222 samples from keyboards and mice, 214 from infusion pumps and 174 from the ward's trolley. From the central ward 16 samples per formites were obtained (computer keyboard and mouse at the physician's workstation and the ward's intercom and telephone receiver). Microbacterial analysis from samples in patients' rooms yielded 26 contaminated samples from keyboard and mouse (5.9%) compared with 18 positive results from other fomites within patients' rooms (3.0%; p < 0.02). At the physician's computer terminal two samples obtained from the mouse (6.3%) showed positive microbial testing whereas the ward's intercom and telephone receiver were not contaminated (p = 0.15).
  
  
  CONCLUSIONS
  The colonization rate for computer keyboard and mouse of a PDMS with potentially pathogenic microorganisms is greater than that of other user interfaces in a surgical ICU. These fomites may be additional reservoirs for the transmision of microorganisms and become vectors for cross-transmission of nosocomial infections in the ICU setting.
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital, Giessen.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hartmann
authors.forename: Matthias
authors.initials: M
authors.lastname: Benson
authors.forename: Axel
authors.initials: A
authors.lastname: Junger
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Quinzio
authors.forename: Rainer
authors.initials: R
authors.lastname: Röhrig
authors.forename: Bernhard
authors.initials: B
authors.lastname: Fengler
authors.forename: Udo W
authors.initials: UW
authors.lastname: Färber
authors.forename: Burkhard
authors.initials: B
authors.lastname: Wille
authors.forename: Gunter
authors.initials: G
authors.lastname: Hempelmann
mesh_terms: D001419:Bacteria / Q000302:isolation & purification; D016287:Computer Peripherals; D003428:Cross Infection; D004784:Environmental Monitoring; D004866:Equipment Contamination; D006751:Hospital Information Systems; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D018570:Risk Assessment; D014584:User-Computer Interface