Adhesive tape in the health care setting: another high-risk fomite?
TO THE EDITOR: We read with interest the article by Pinto and colleagu.es regarding colonisation of reusable tourniquets by multiresistant organisms (MROs). l We highlight that surgical adhesive tape also has the potential to act as a significant fomite in health care settings.
We collected partially used surgical tape rolls from several clinical areas of three hospitals in the Hunter New England Area Health Service. Using hands disinfected with alcohol gel, tape rolls from different locations in each area were placed into 21 dean collection bags (up to three tapes peT bag).
Tapes from each batch were placed in. 21 stctilc containe.rs with 15 mL of brain-heart infusion broth and incubated overnight at 35’C in carbon dioxide. The broths were subcultured onto Columbia horse-blood agar (Oxoid Australia, Adelaide, SA), MacConkey agar (Oxoid) and differential selective media to detect vancomycin-resistant enterococci (VRE) (chromID VRE; bioMerieux, Marcv J.:Etoile, France), methicillin- .’ resistant Staphylococcus aureus (MRSA) (Brilliance MRSA; Oxoid) and multiresistant gram- negative bacteria (chromlD ESBL; bioMerieux). A multiplex tandem polymerase chain reaction assay (MRSA4; AusDiagnostics, Sydney, NSW) to detect MRSA and methicillin-susceptible S. aurcus (MSSA) was also performed on all broth cultures. Routine species level identification was performed (VHEK MS; bioMerieux). Susceptibility was determined in accordance \\lith Clinical and Laboratory Standards Institute criteria. 2
In 11 of the 21 tape batches, MRSA andlor VRE were identified. Of these, four were positive for MRSA and 10 for VRE, with three positive for both. MSSA was identified in two, both in association with VRE. All batches showeed evidence of contaminati.on with other bacteria such as Bacillus f erellS, coagulase-negative staphylococci, non -muJtiresistant Enterobacteriaceac, Pseudomonas spp, Acinetobacter spp and other enterococci.
Our results indicatc that surgical adhesive tapes arc frequently contaminated with MROs. Interpretation of these results is limited by the small number of tapes and clinical areas sampled, and the difficulty of prO\ing a relationship to clinical infection. However, items such as intravenous cannulae, surgical drains and wound dressings are frequently fjxed usjng surgical adhesive tape. This may lead to colonisation and subsequent infection. Furthermore, tape rolls are often left lying on contamillatcd surfaces, arc handled by multjple individuals and cannot be disinfected.
Surgical adhesive tape is a potential reservoir of pathogenic bacteria3 and fungi4 and was implicated in a prolonged S. aure-us outbreak in a neonatal unit.s The role of surgical tape as a potential fomite was reported in 1974′ but has not been widely acknowledged since.
Removing the outer layer of the tape roll is unlikely to reduce contamination, given visible contamination of the side of many rolls (Figure).’ Short rolls of surgi~al adhesive tape should be supplied in.