When I first saw this headline: Fox 25 Investigates: Hidden hospital germs I geared up for YASS – yet another swab story (this is a bit of a play on the “swab story” complaint Mark Martin uses for stories that report on microbes found by swabbing.
– Jonathan Eisen (@phylogenomics) November 26, 2013
But despite my instinct, this story is in a way a hidden gem. First, they based what they did on a new published paper and they even link to and discuss the paper itself. The paper is “Elevator buttons as unrecognized sources of bacterial colonization in hospitals” published in Open Medicine, which I am happy to say is an open access journal.
The abstract for the paper is below:
Background: Elevators are ubiquitous and active inside hospitals, potentially facilitating bacterial transmission. The objective of this study was to estimate the prevalence of bacterial colonization on elevator buttons in large urban teaching hospitals.
Methods: A total of 120 elevator buttons and 96 toilet surfaces were swabbed over separate intervals at 3 tertiary care hospitals on weekdays and weekends in Toronto, Ontario. For the elevators, swabs were taken from 2 interior buttons (buttons for the ground floor and one randomly selected upper-level floor) and 2 exterior buttons (the “up” button from the ground floor and the “down” button from the upper-level floor). For the toilet surfaces, swabs were taken from the exterior and interior handles of the entry door, the privacy latch, and the toilet flusher. Samples were obtained using standard bacterial collection techniques, followed by plating, culture, and species identification by a technician blind to sample source.
Results: The prevalence of colonization of elevator buttons was 61% (95% confidence interval 52%—70%). No significant differences in colonization prevalence were apparent in relation to location of the buttons, day of the week, or panel position within the elevator. Coagulase-negative staphylococci were the most common organisms cultured, whereas Enterococcus and Pseudomonas species were infrequent. Elevator buttons had a higher prevalence of colonization than toilet surfaces (61% v. 43%, p = 0.008).
Conclusion: Hospital elevator buttons were commonly colonized by bacteria, although most pathogens were not clinically relevant. The risk of pathogen transmission might be reduced by simple countermeasures.
The paper is pretty simple and as far as I can tell does not oversell, or undersell, their findings. They also have some useful references to microbial transmission in hospitals I was not aware of so overall, I am glad the Fox story pointed me to this paper.
Back to the news story. In some sense – it is akin to these “swab story” report where people go to some site, swab it, and count the microbes that grow and report how scary some site or type of object is. But this article is a bit different. For example, they discuss the issue of how not all bacteria will make you sick:
We tested four Oklahoma City metro hospitals, but first consulted Rose State College microbiology professor Dr. Amy Hurst about how we should conduct our test. She recommended using diagnostic plates to grow specific bacterial cultures. “In any situation you’re going to find bacteria, what you really care about are the ones that are going to make you ill,” Dr. Hurst told Fox 25.
Sure they then go an use three different growth conditions and no longer focus on the issue of good vs. bad germs. But still – they seem to have tried to discuss this issue. They report to have found bacteria associated with Strep throat due to growth on certain blood agar plates. I am not sure how accurate this is, but I will just assume this is an OK test.
And then, perhaps the most interesting part to me, is the responses they got from hospitals when they went to them with their results. Anyway – it is not a perfect new story. It has some flavors of YASS – yet another swab story. But unlike most such stories, it references an actual scientific paper, and it tries to discuss issues like “not all germs are bad”. So, overall, I am happy I red the story.