title: Assessment and risk reduction of infectious pathogens on chiropractic treatment tables.
abstract: BACKGROUND
  To investigate the presence of pathogenic microbes on chiropractic treatment tables in one outpatient teaching clinic. Additional aims were to test inexpensive disinfectants on tables that may kill microbes and suggest infection control measures for chiropractic offices, clinics and classrooms. The aim of the study was to assess the presence of pathogenic microbes on treatment tables in one outpatient teaching clinic and determine a simple behavioral model for infection control including table disinfection and accepted hand washing and sanitizing protocols.
  
  
  METHODS
  10 treatment tables were selected and sampled for possible microbial flora on face and hand pieces. Samples were cultured on MacConky's agar and mannitol salt agar, labeled and incubated for up to 48 hours. Confirmatory testing of microbes to determine if drug resistant flora were present was performed. Among tables tested, 5 were selected to test disinfectants. One-half of the face piece and 1 hand piece were treated with two different wipes and then post-tested for microbes.
  
  
  RESULTS
  Pathogenic microbes were present on chiropractic treatment tables including methicillin-resistant Staph aureus. Simple disinfectants neutralized the pathogens. A rudimentary disinfection procedure and infection control measures are suggested based on the findings.
  
  
  CONCLUSIONS
  Pathogenic microbes may be present on chiropractic treatment tables and can be effectively killed with proper disinfecting. Hand washing/sanitizing is an important measure in infection control as is table disinfecting. Rudimentary behavioral changes to improve chiropractic clinic infection control are needed. More comprehensive behavioral models are needed. All teaching clinics and private chiropractic offices should adopt infection control practices including routine table disinfecting and hand sanitizing. Effective measures can be put in place at minimal costs. Accrediting bodies of chiropractic institutions should mandate an infection control plan for member institutions immediately.
authors.affiliation: Associate Professor, Parker College of Chiropractic, Research Institute, 2500 Walnut Hill Lane, Dallas, Texas 75229, USA.
authors.forename: Marion Willard
authors.initials: MW
authors.lastname: Evans
authors.affiliation: Assistant Professor, Parker College of Chiropractic, Research Institute, USA.
authors.forename: Jennell
authors.initials: J
authors.lastname: Breshears
authors.affiliation: Professor, Department of Basic Sciences, Microbiology, Parker College of Chiropractic, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Campbell
authors.affiliation: Laboratory Manager of Pathological and Physiological Sciences, Parker College of Chiropractic, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Husbands
authors.affiliation: Dean of Research, Parker College of Chiropractic, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Rupert