Is there a risk for bacterial transmission from surgical marker pens?

P Brinskelle; E Koenig; G Sendlhofer; K A Baumhackl; R Winter; I Sawetz; L P Kamolz; I Steinmetz; H Friedl; D B Lumenta

doi:10.1016/j.jhin.2020.08.003

Is there a risk for bacterial transmission from surgical marker pens?

J Hosp Infect. 2020 Oct;106(2):254-257. doi: 10.1016/j.jhin.2020.08.003. Epub 2020 Aug 12.

Authors

P Brinskelle¹, E Koenig², G Sendlhofer³, K A Baumhackl⁴, R Winter¹, I Sawetz¹, L P Kamolz³, I Steinmetz⁴, H Friedl⁵, D B Lumenta⁶

Affiliations

¹ Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
² Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria. Electronic address: elisabeth.ullrich@medunigraz.at.
³ Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
⁴ Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.
⁵ Institute of Statistics, Graz University of Technology, Graz, Austria.
⁶ Research Unit for Tissue Regeneration, Repair and Reconstruction, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.

PMID: 32795568
DOI: 10.1016/j.jhin.2020.08.003

Abstract

Markers for preoperative skin marking are used several times and bear a risk of transmitting bacteria. Bacterial contamination was assessed by sonication and culture. Antimicrobial susceptibility testing (AST) was performed for facultative pathogens to assess multi-drug resistance (MDR). An accelerated failure time model was applied to assess the statistical relationship between the bacterial contamination and the filling status of markers. Of 45 markers, 13 had a colony count <10 cfu/mL and 32 had counts from 10 to 12,500 cfu/mL. Three markers were colonized by Staphylococcus aureus. No MDR bacteria were found. We recommend single use of markers to reduce transmission risk.

Keywords: Bacterial contamination; Colonization; Markers; Multi-drug resistance; Sonication; Surgical site identification.

MeSH terms

Anti-Bacterial Agents / pharmacology
Bacteria / classification
Bacteria / isolation & purification*
Bacterial Infections / transmission*
Colony Count, Microbial
Drug Resistance, Multiple, Bacterial
Equipment Contamination*
Humans
Microbial Sensitivity Tests
Preoperative Care / instrumentation*
Staphylococcal Infections / microbiology
Staphylococcal Infections / transmission
Surgical Equipment / microbiology*

Substances

Anti-Bacterial Agents