title: Microbial colonization of electrocardiographic telemetry systems before and after cleaning.
abstract: BACKGROUND
  Nosocomial infections caused by multidrug-resistant organisms are commonly associated with longer hospital stays up to 12 to 18 days and annual estimated costs of $5.7 billion to $6.8 billion. One common mode of transmission is cross-contamination between patients and providers via surface contaminants on devices such as telemetry systems.
  
  
  OBJECTIVE
  To determine the effect of a cleaning protocol on colonization of surface contaminants on electrocardiographic telemetry systems in 4 cardiovascular step-down units and to compare colonization in medical vs surgical units.
  
  
  METHODS
  A prospective, randomized, case-controlled study (the Descriptive Evaluation of Electrocardiographic Telemetry Pathogens [DEET] study) was designed to evaluate microbial colonization on telemetry systems before and after cleaning with sodium hypochlorite wipes. Each randomly selected telemetry system served as its own control. Nurses used a standardized culture technique recommended by personnel in infection control. Colonization before and after cleaning was analyzed by using the McNemar test and frequency tables. A standard cost-comparison analysis was conducted.
  
  
  RESULTS
  A total of 30 telemetry systems in medical units and 29 in surgical units were evaluated; 41 telemetry systems (69%) were colonized before the intervention, and 14 (24%) were colonized after it (P < .001). Before cleaning, surface organisms were present in 14 instances (35%) in surgical units and in 27 instances (66%) in medical units (P < .001). The cleaning strategy was cost-effective.
  
  
  CONCLUSIONS
  The cleaning intervention was effective, and cost-comparison analysis supported implementing a cleaning strategy for reusable leads rather than investing in disposable leads.
authors.affiliation: Duke University Hospital, Durham, NC, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Reshamwala
authors.forename: Kathryn
authors.initials: K
authors.lastname: McBroom
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Choi
authors.forename: Linda
authors.initials: L
authors.lastname: LaTour
authors.forename: Antoinette
authors.initials: A
authors.lastname: Ramos-Embler
authors.forename: Rowena
authors.initials: R
authors.lastname: Steele
authors.forename: Virginia
authors.initials: V
authors.lastname: Lomugdang
authors.forename: Margaret
authors.initials: M
authors.lastname: Newman
authors.forename: Colleen
authors.initials: C
authors.lastname: Reid
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Zhao
authors.forename: Bradi B
authors.initials: BB
authors.lastname: Granger
mesh_terms: D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000517:prevention & control*; D046508:Culture Techniques; D004209:Disposable Equipment / Q000191:economics*; D004562:Electrocardiography / Q000295:instrumentation*; D004866:Equipment Contamination / Q000517:prevention & control*; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D011446:Prospective Studies; D013686:Telemetry / Q000295:instrumentation*