CHICAGO — Reusable ECG leads have come under scrutiny as reservoirs for multidrug-resistant bacterial pathogens that may potentially play an important role in serious nosocomial infections in hospitalized patients.
At the annual Interscience Conference on Antimicrobial Agents and Chemotherapy, Dr. Paul R. Brookmeyer characterized ECG telemetry leads, which are cleaned and reused in most hospitals, as “an unappreciated reservoir” of multidrug-resistant nosocomial pathogens.
“It is plausible that unrecognized but widespread contamination of ECG lead wires is an important mechanism of cross-infection in hospitals, especially of resistant nosocomial bacteria such as methicillin-resistant coagulase-negative streptococci, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, gram-negative bacilli resistant to extended-spectrum β-lactams, and Clostridium difficile,” said Dr. Brookmeyer of University of Wisconsin Hospital and Clinics, Madison.
He cultured 100 randomly selected ECG telemetry leads after they had been reprocessed and immediately before their planned attachment to new ICU patients. Among the key findings: 77% of the ECG leads were contaminated with one or more antibiotic-resistant nosocomial pathogens. Overall, 67% of leads were contaminated with methicillin-resistant S. aureus, 17% with vancomycin-resistant enterococci, and 12% with gram-negative bacilli resistant to extended-spectrum β-lactams.
Moreover, failure to decontaminate ECG leads was implicated by epidemiologists as the cause of an outbreak of Serratia marcescens infection. And an outbreak of vancomycin-resistant enterococcal infection in a burn unit was determined to have perpetuated by a contaminated ECG lead wire harness.
“We believe our findings are representative of hospitals worldwide. Attachment of contaminated lead wires to a new patient can result in colonization and ultimately in invasive infection by multiresistant nosocomial microorganisms. … Moreover, the extent of bacterial contamination we found would suggest that lead wires can also become contaminated by nosocomial viruses, such as respiratory syncytial virus, rotavirus, hepatitis viruses, and the SARS virus,” he said.
More effective means of decontaminating ECG lead wires are needed. Routine use of wireless telemetry would eliminate the problem, he said.