title: Identity tags: A vector for cross-infection?
abstract: BACKGROUND
  Nosocomial infections represent one of the challenging problems of modern medicine. Healthcare providers play an important role in the transmission of these infections on their hands, clothing and equipment. Modern security systems require personnel to wear clearly displayed identity (ID) tags, and to have an easily accessible access disc. These access and ID tags are often worn around the neck on a lanyard, and could possibly harbour bacteria and be a vector for cross-infection.
  
  
  METHODS
  Saline-moistened swabs of the front and back of ID tags of 50 healthcare workers were taken for bacterial culture. Swabs were inoculated onto standard microbiological media. Potential pathogens were subjected to sensitivity testing while organisms resembling normal skin commensals were reported as such.
  
  
  RESULTS
  Twenty-eight of the 50 (56%) ID swabs cultured exhibited no bacterial growth. Eighteen (36%) swabs grew primarily skin flora. Neutrophils were observed under microscopy on two (4%) swabs. Seven (14%) swabs grew potentially pathogenic bacteria. Doctors were found to have almost three times the risk of carrying pathogenic bacteria on their ID tags compared with nurses. Recent patient contact also showed a higher incidence of colonisation. There were no statistically significant differences between variables such as ward or area of work, nature of patient contact, time since qualification, level of qualification or length of employment at Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
  
  
  CONCLUSIONS
  Prevention of hospital-acquired infections is important in any setting. The ID tag has been identified as a possible source of infection spread in this and previous studies. The ID tag has to date been neglected as a potential source of pathogen spread, and efforts to make staff aware of this potential danger should be considered in every institution.
authors.affiliation: Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and University of Cape Town, South Africa. sharon.cox@uct.ac.za.
authors.forename: Sharon Gail
authors.initials: SG
authors.lastname: Cox
authors.forename: Abdus
authors.initials: A
authors.lastname: Burahee
authors.forename: Amanda
authors.initials: A
authors.lastname: Lucier
authors.forename: Chamara
authors.initials: C
authors.lastname: Fernando
authors.forename: Stanley
authors.initials: S
authors.lastname: Mugambi Machoki