Study: Better x-ray equipment infection control needed

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Multi-resistant bacteria are frequently transferred from patients to the radiograph machine in the presence of poor infection control practices, and may be a source of cross-infection or colonization, according to a study published in the August issue of Chest.

Approximately 15 percent of nosocomial infections in the ICU result from spread of bacteria on caregivers' hands. The routine chest radiograph provides an unexamined opportunity for bacterial spread: close contact with each patient and sequential exam of ICU patients, according to Phillip D. Levin, MB BChir, from the department of anesthesiology and critical care medicine at the Hebrew University-Hadassah Medical School in Jerusalem, and colleagues.

The researchers sought to examine infection control procedures performed during routine chest radiographs, assessed whether resistant bacteria were transferred to the radiograph machine and determined whether improved infection control practices by radiograph technicians could reduce bacterial transfer.

They observed radiograph technicians performing chest radiographs on all ICU patients. The investigators then took culture specimens from the radiograph machine.

Levin and colleagues performed surveillance of 173, 113 and 120 chest radiographs during observation, intervention and follow-up periods. Adequate infection control was practiced during the performance of 1 percent of the observation period radiographs (only two procedures), 42 percent of the intervention period radiographs and 10 percent of the follow-up period radiographs, according to the authors.

Radiograph machine surface culture samples yielded resistant Gram-negative bacteria in 39 percent of occasions in the observation period, zero percent in the intervention period and 50 percent in the follow-up period.

The authors wrote that “[i]mproved infection control practices decrease the occurrence of resistant organisms on the radiograph equipment.” Also, they noted that radiograph technicians should be included in efforts to improve infection control measures.