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What’s on your keyboard? A systematic review of the contamination of peripheral computer devices in healthcare settings
  1. Nicole Ide1,
  2. Bianca K Frogner1,
  3. Cynthia M LeRouge2,
  4. Patrick Vigil3,
  5. Matthew Thompson1
  1. 1 Department of Family Medicine, University of Washington, Seattle, Washington, USA
  2. 2 Department of Information Systems & Business Analytics, Florida International University, Miami, Florida, USA
  3. 3 Family Medicine, Pacific Northwest University, Yakima, Washington, USA
  1. Correspondence to Dr Matthew Thompson; mjt{at}uw.edu

Abstract

Objective To determine the extent and type of microbial contamination of computer peripheral devices used in healthcare settings, evaluate the effectiveness of interventions to reduce contamination of these devices and establish the risk of patient and healthcare worker infection from contaminated devices.

Design Systematic review

Methods We searched four online databases: MEDLINE, CINAHL, Embase and Scopus for articles reporting primary data collection on contamination of computer-related equipment (including keyboards, mice, laptops and tablets) and/or studies demonstrating the effectiveness of a disinfection technique. Pooling of contamination rates was conducted where possible, and narrative synthesis was used to describe the rates of device contamination, types of bacterial and viral contamination, effectiveness of interventions and any associations between device contamination and human infections.

Results Of the 4432 records identified, a total of 75 studies involving 2804 computer devices were included. Of these, 50 studies reported contamination of computer-related hardware, and 25 also measured the effects of a decontamination intervention. The overall proportion of contamination ranged from 24% to 100%. The most common microbial contaminants were skin commensals, but also included potential pathogens including methicillin-resistantStaphylococcus aureus, Clostridiumdifficile, vancomycin-resistantenterococci and Escherichia coli. Interventions demonstrating effective decontamination included wipes/pads using isopropyl alcohol, quaternary ammonium, chlorhexidine or dipotassium peroxodisulfate, ultraviolet light emitting devices, enhanced cleaning protocols and chlorine/bleach products. However, results were inconsistent, and there was insufficient data to demonstrate comparative effectiveness. We found little evidence on the link between device contamination and patient/healthcare worker colonisation or infection.

Conclusions Computer keyboards and peripheral devices are frequently contaminated; however, our findings do not allow us to draw firm conclusions about their relative impact on the transmission of pathogens or nosocomial infection. Additional studies measuring the incidence of healthcare-acquired infections from computer hardware, the relative risk they pose to healthcare and evidence for effective and practical cleaning methods are needed.

  • infection control
  • contamination
  • healthcare-acquired infection
  • nosocomial infection
  • keyboard

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors NI and MT designed the study methodology and conducted the literature search. NI extracted data from selected studies and MT checked extracted data for accuracy. NI and MT performed data analysis and developed the original draft of the article, and contributed towards further drafts. Data interpretation and critical revision of the manuscript was done by BKF, CML and PV. All authors reviewed and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The complete data extraction form, quality assessment tables, and full search strategy can be made available upon request to the study authors.

  • Patient consent for publication Not required.

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