title: Surface microbiology of the iPad tablet computer and the potential to serve as a fomite in both inpatient practice settings as well as outside of the hospital environment.
abstract: BACKGROUND
  The use of tablet computers and other touch screen technology within the healthcare system has rapidly expanded. It has been reported that these devices can harbor pathogens in hospitals; however, much less is known about what pathogens they can harbor when used outside the hospital environment compared to hospital practice.
  
  
  METHODS
  Thirty iPads belonging to faculty with a variety of practice settings were sampled to determine the presence and quantity of clinically-relevant organisms. Flocked nylon swabs and neutralizer solution were used to sample the surface of each iPad. Samples were then plated on a variety of selective agars for presence and quantity of selected pathogens. In addition, faculty members were surveyed to classify the physical location of their practice settings and usage patterns. Continuous variables were compared via an unpaired Student's t test with two-tailed distribution; categorical variables were compared with the Fisher's exact test.
  
  
  RESULTS
  Of the iPads sampled, 16 belonged to faculty practicing within a hospital and 14 belonged to a faculty member practicing outside a hospital. More faculty within the hospital group used their iPads at their practice sites (78.6% vs. 31.3%; p = 0.014) and within patient care areas (71.4% vs. 18.8%; p = 0.009) than the non-hospital group. There were no differences in the presence, absence, or quantity of, any of the pathogens selectively isolated between groups. Problematic nosocomial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and P. aeruginosa were isolated from both hospital and non-hospital faculty iPads.
  
  
  CONCLUSIONS
  Gram positive and Gram negative organisms were recovered from the surfaces of iPads regardless of practice setting; these included problematic multidrug-resistant pathogens like MRSA, VRE, and Pseudomonas aeruginosa. Healthcare personnel in all settings should be aware of the potential for tablet computers to serve as a nidus for microorganism transmission.
authors.affiliation: Northeastern University, Bouvé College of Health Sciences, School of Pharmacy, Boston, Massachusetts, United States of America.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Hirsch
authors.affiliation: Northeastern University, Bouvé College of Health Sciences, School of Pharmacy, Boston, Massachusetts, United States of America.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Raux
authors.affiliation: Northeastern University, Bouvé College of Health Sciences, School of Pharmacy, Boston, Massachusetts, United States of America.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Lancaster
authors.affiliation: Northeastern University, Bouvé College of Health Sciences, School of Pharmacy, Boston, Massachusetts, United States of America.
authors.forename: Rachael L
authors.initials: RL
authors.lastname: Mann
authors.affiliation: Northeastern University, Bouvé College of Health Sciences, School of Pharmacy, Boston, Massachusetts, United States of America.
authors.forename: Steven N
authors.initials: SN
authors.lastname: Leonard
mesh_terms: D003201:Computers / Q000706:statistics & numerical data; D003625:Data Collection; D004783:Environmental Microbiology; D050456:Fomites / Q000382:microbiology*; D006761:Hospitals; D006801:Humans; D013499:Surface Properties