The document presents research conducted by Hibah Abdul-Wahab Abu-Sulaiman on the presence of harmful bacteria on healthcare swipe cards and scanners used by doctors. The study revealed that 20.5% of swipe cards were contaminated with pathogenic bacteria, while 88% of scanners also hosted environmental pathogens. Conclusions suggest that proper cleaning methods, specifically with alcohol, effectively eliminate bacteria, and that the carrying practices of cards significantly influence contamination.

1. Hibah Abdul- Wahab Abusulaiman Umm Al-Qura University Makkah, Saudi 'Arabia Collage of Applied Medical Sciences Laboratory Medicine Microbiology Department December 3 rd , 2011

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3. Who is she? She invented…? Lisa Holmes

4. I will Keep the Best Part for the End You will Guess…

5. In her invention, she considered… Smartcards, Credit Cards, Identification Cards, Healthcare Cards, Employee Badges, Rewards Cards, Chips, and Tokens and transmission of microbes and pathogens that thrive on there surfaces.

6. A study speaks about…

7. It took the concern of…

8. The Presentation’s Outline The research problem. The aim of the study. Methodology. Results. Conclusion. Critique. Recommendation. Lisa’s invention.

10. The Research Problem

12. The Aim of the Study 1 To determine if swipe cards and wall- mounted scanners harbour potentially harmful bacteria

14. Methodology Sample: Study population: 45 doctors working in the departments of: general, orthopedic and urological surgery at the Queen Elizabeth Hospital, Kings Lynn, UK. 39 consented and their security swipe cards. Scanners: 16 swipe- cards scanners in that words.

15. Methodology 1 Questionnaire completion. 2 Culturing participant’s swipe cards 3 Determining if swipe-cards scanners harbour bacteria

16. Methodology To determine: Where they kept their swipe card while working. Frequency of its usage. Clinical accessed areas through their cards in the past 24 hrs. Frequency and methods of cleaning their cards. 1 Questionnaire completion:

17. Methodology Tryptone Soya Agar (TSA) Aerobically at 36 O C for 24 hrs at 30 O C for 48 hrs Incubated 2 Culturing participant’s swipe cards:

18. Methodology Using sterile swipe cards TSA Aerobically at 36 O C for 24 hrs at 30 O C for 48 hrs Incubated 3 Determining if swipe- cards scanners harbour bacteria

19. Methodology Scrubbing with soap and water for 30 seconds. Scrubbing with hibiscrub for 30 seconds. Cleaning with an alcohol- soaked swab for 15 seconds. TSA Aerobically at 36 O C for 24 hrs at 30 O C for 48 hrs Incubated 4 Assessing three methods of cleaning swipe cards:

20. Methodology Using sterile swipe cards ( drawn x3) Cleaning for 15 s TSA Aerobically at 36 O C for 24 hrs at 30 O C for 48 hrs Incubated 5 Assessing a single method for cleaning scanners:

21. Methodology Following incubation: Antibiotic Sensitivity Testing (AST) Detection of : S. aureus, MRSA, Enterococcus spp., coliforms and Pseudomonas spp. Colony Count (CFU)

23. Results % in respect to 39 participants Mean number CFUs Colonised with pathogenic bacteria: n (%) % of colonized with pathogenic bacteria in respect to the 39 participants 73 20.5% And 79.5% were environmental bacteria Grade Consultant (n= 10) 25.64% 59 3 (30% ) 7.69% Middle- grade (n= 13) 33.33% 92 5 (38% ) 12.82% House officer (n= 16) 41.02% 68 -- 0% Specialty General surgery (n= 23) 58.97% 73 5 (22% ) 12.82% Orthopedics (n= 12) 30.76% 84 2 (17% ) 5.12% Urology (n= 4) 10.25% 46 1 (25% ) 2.56%

24. Results % in respect to 39 participants Mean number CFUs Colonised with pathogenic bacteria: n (%) % of colonized with pathogenic bacteria in respect to the 39 participants Frequency of use Frequent (> 15 times/ wk) n= 19 48.71% 52 5 (26% ) 12.82% Moderate (5- 15 times/ wk) n= 14 35.89% 86 3 (21% ) 7.69% Occasional (< 5times/ wk) n= 6 15.38% 113 -- 0% Where card kept Necklace (n= 11) 28.20% 54 1 (9% ) 2.56% Belt (n= 13) 33.33% 55 2 (15% ) 5.12% Pocket (n= 15) 38.46% 108 5 (33% ) 12.82% Card cleaned Never (n= 32) 82.05% 83 6 (19% ) 15.38% Yes (n= 7) 17.94% 29 2 (29% ) 5.12%

25. Results Overall, 8 (20.5%) were contaminated with potentially pathogenic bacteria including S. aureus, Pseudomonas putida and coliforms. One of the latter bacteria being resistant to ampicillin.

27. Scanners Results Bacteria were cultured from 14 of 16 scanners (88%) examined. All the bacteria cultured were environmental pathogens.

28. There was wide variation in the number of CFUs cultured from different scanners. The highest counts being obtained from scanners adjacent to main operating theaters, the day- surgery unit and the administration block.

30. Card Cleaning Results No bacteria were cultured from swipe cards following a 30s wash with hibiscrub or a 15s with an alcohol- soaked swab. 31 CFUs were cultured from cards cleaned by washing in soap and water for 30s.

32. Scanner Cleaning Results No bacteria were cultured from scanners following cleaning with alcohol swabs.

34. Conclusion The majority of cards and scanners were contaminated by environmental bacteria with low pathogenic potential. Bacteria with significant pathogenic potential, and implicated as causes of nosocomial infection were isolated from 20.5% of swipe cards.

35. Conclusion Two thirds of these 20.5% pathogenic contaminated cards were kept in wallets or pockets. Large numbers of bacteria were transferred from card to scanner, and scanner to card during experimental use.

36. Conclusion All contaminated cards were carried by consultants and middle- grade surgeons suggests that duration of use of a card may be of relevance. Previous cleaning of swipe cards by owners resulted in a notable, but non-significant, reduction in the number of CFUs isolated.

37. Conclusion Cleaning cards and scanners with alcohol in a controlled fashion effectively removed all bacteria.

38. Conclusion There is no correlation between colonization with pathogenic bacteria and any of the other recorded parameters, including how the cards was carried, frequency of use, areas of use and cleaning practice.

40. Critique The aim of the study was fully covered through its methodology.

42. Methodology Critique The three methods of cleaning the swipe cards were not well described. In the methodology: the researchers did not justify the fluctuation in incubation temperature, as long as they are looking for bacteria only not bacteria and moulds.

44. Results Critique Author: Insignificant Significant Results Mean number CFUs Colonised with pathogenic bacteria: n (%) % of colonized with pathogenic bacteria in respect to the 39 participants Grade Consultant (n= 10) 59 3 (30% ) 7.69% Middle- grade (n= 13) 92 5 (38% ) 12.82% House officer (n= 16) 68 -- 0% Specialty General surgery (n= 23) 73 5 (22% ) 12.82% Orthopedics (n= 12) 84 2 (17% ) 5.12% Urology (n= 4) 46 1 (25% ) 2.56%

45. Results Critique Author: Insignificant Significant Results Mean number CFUs Colonised with pathogenic bacteria: n (%) % of colonized with pathogenic bacteria in respect to the 39 participants Frequency of use Frequent (> 15 times/ wk) n= 19 52 5 (26% ) 12.82% Moderate (5- 15 times/ wk) n= 14 86 3 (21% ) 7.69% Occasional (< 5times/ wk) n= 6 113 -- 0% Where card kept Necklace (n= 11) 54 1 (9% ) 2.56% Belt (n= 13) 55 2 (15% ) 5.12% Pocket (n= 15) 108 5 (33% ) 12.82% Card cleaned Never (n= 32) 83 6 (19% ) 15.38% Ever (n= 7) 29 2 (29% ) 5.12%

46. Results Critique Author: “ There is no correlation between colonization with pathogenic bacteria and any of the other recorded parameters, including how the cards was carried, frequency of use, areas of use and cleaning practice”. ↑ Usage frequency-> ↓ Hiding card-> ↓Bacteria

47. Results Critique The study did not mention an exact number or percentage of each pathogenic bacteria isolated from cards.

49. Recommendation Always be sure of wearing such cards on a necklace or belt. Be aware of cleaning that card and its scanners with alcohol.

51. So what do you think she invented? Lisa Holmes

52. Lisa Holmes

54. Any Questions?! Hibah A. W. Abu-Sulaiman