title: Bacterial contamination of re-usable laryngoscope blades during the course of daily anaesthetic practice.
abstract: OBJECTIVE
  Hospital-acquired infections (HAIs) are largely preventable through risk analysis and modification of practice. Anaesthetic practice plays a limited role in the prevention of HAIs, although laryngoscope use and decontamination is an area of concern. We aimed to assess the level of microbial contamination of re-usable laryngoscope blades at a public hospital in South Africa.
  
  
  METHODS
  The theatre complex of a secondary-level public hospital in Johannesburg.
  
  
  METHODS
  Blades from two different theatres were sampled twice daily, using a standardised technique, over a 2-week period. Samples were quantitatively assessed for microbial contamination, and stratified by area on blade, theatre and time using Fisher's exact test.
  
  
  RESULTS
  A contamination rate of 57.3% (63/110) was found, with high-level contamination accounting for 22.2% of these. Common commensals were the most frequently isolated micro-organisms (79.1%), but important hospital pathogens such as Enterobacter species and Acinetobacter baumannii were isolated from blades with high-level contamination. No significant difference in the level of microbial contamination by area on blade, theatre or time was found (p<0.05).
  
  
  CONCLUSIONS
  A combination of sub-optimal decontamination and improper handling of laryngoscopes after decontamination results in significant microbial contamination of re-usable laryngoscope blades. There is an urgent need to review protocols and policies surrounding the use of these blades.
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, South Africa. warren.lowman@wits.ac.za
authors.forename: Warren
authors.initials: W
authors.lastname: Lowman
authors.forename: Laurissa
authors.initials: L
authors.lastname: Venter
authors.forename: Juan
authors.initials: J
authors.lastname: Scribante
mesh_terms: D000758:Anesthesia; D001419:Bacteria / Q000302:isolation & purification*; D003428:Cross Infection / Q000382:microbiology* / Q000517:prevention & control; D004866:Equipment Contamination; D006801:Humans; D017053:Infection Control / Q000379:methods; D020704:Laryngoscopes / Q000382:microbiology*; D011446:Prospective Studies; D013019:South Africa