Sybil Edmonds

Worse than toilets: hospital elevator buttons a hidden source of bacteria

sgupta — Tue, 08 Jul 2014 14:19:17 +0000

Worse than toilets: hospital elevator buttons a hidden source of bacteria sgupta Tue, 07/08/2014 - 10:19

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“Use alcohol-based hand sanitizer before and after touching the buttons, or avoid touching them altogether by using the tip of a pen or your elbow,” suggests Dr. Christopher Kandel (photo by Allan Foster via Flickr)

Sybil Edmonds

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Sybil Edmonds

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“We were surprised by the frequency of bacterial colonization"

Elevator buttons are more likely to be colonized by bacteria than toilet surfaces, a new study of three large urban hospitals has found.

“Elevators are a component of modern hospital care, and are used by multiple people with ungloved hands who will later go on to make contact with patients,” said University of Toronto professor, Dr. Donald Redelmeier, co-author of the study and staff physician, division of general internal medicine at Sunnybrook Health Sciences Centre and researcher with the Institute for Clinical Evaluative Sciences (ICES).

At each hospital, 120 randomly selected interior and exterior elevator buttons were swabbed over a ten-day period. These were compared against swabs of toilet surfaces in men’s washrooms, including exterior and interior entry-door handles, the privacy latch and the toilet flusher.

Sixty-one percent of the elevator button samples showed microbiological growth, compared to only 43% of the toilet surface samples. Bacteria cultured from the elevator buttons and toilet surfaces included Staphylococcus, Streptococcus, coliform (or bowel) bacteria, Enterococcus and Pseudomonas, though they are unlikely to cause specific diseases in most cases. (Infographic at right courtesy Sunnybrook Health Sciences Centre.)

“We were surprised by the frequency of bacterial colonization on the elevator buttons, but we were also struck by how easily it could be avoided, specifically by the use of good hand washing or hand hygiene,” said co-author Dr. Andrew Simor, a professor of Medicine and of Laboratory Medicine and Pathobiology at U of T and chief, department of microbiology and infectious diseases at Sunnybrook.

The authors suggest several strategies for reducing the frequency of bacterial colonization on commonly touched surfaces.

“Use alcohol-based hand sanitizer before and after touching the buttons, or avoid touching them altogether by using the tip of a pen or your elbow,” said lead author Dr. Christopher Kandel, a fellow, department of infectious diseases, at U of T.

“Educating the public about the importance of hand hygiene when in a hospital may also help reduce the rate of colonization.”

The study was published today in Open Medicine Journal.

Sybil Edmonds is a writer with Sunnybrook Health Sciences Centre, a partner hospital of the University of Toronto.

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Cesarean no safer than vaginal delivery for twins

sgupta — Tue, 12 Feb 2013 14:54:36 +0000

Cesarean no safer than vaginal delivery for twins sgupta Tue, 02/12/2013 - 09:54

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Cesarean section isn't preferable for twins. (photo by Jim Parker via Flickr)

Sybil Edmonds

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Delivering twins by planned vaginal birth is just as safe as delivering them by planned cesarean section, according to the newly released findings of a multi-site trial led by University of Toronto researcher, Professor Jon Barrett from the Department of Obstetrics and Gynecology.

“Our findings show that planned vaginal birth is the correct method for delivering twins in a pregnancy that is otherwise uncomplicated, and when the first baby is facing head down,” says Barrett. “We found that there is no reason for doctors or women to be planning to deliver twins by cesarean section, as the babies’ outcomes remain the same regardless of how they are delivered.”

The findings of the study, which involved 106 centres in 25 countries, were presented this week at the Society for Maternal-Fetal Medicine Annual Meeting in San Francisco. Nearly a decade in the making, it is the only large scale, randomized controlled trial that has been undertaken to determine the optimal method of delivering twins.

The study randomized 2,804 women with twin pregnancies, in which the first baby faced head down, for either a planned cesarean section or planned vaginal delivery. Women were enrolled between 2003 and 2011, and randomization was centrally controlled at the Centre for Mother, Infant and Child Research at Sunnybrook Health Sciences Centre, part of the University Health Network. Mothers and infants were followed to 28 days after birth.

As the number of multiple births in Canada and around the world has risen, so too has the trend of delivering twins by planned cesarean section. Barrett says he hopes the results of this study will help women and their physicians choose the method of delivery that is right for them.

“People are often not sure what the right delivery method is and sometimes default to cesarean section because they perceive it to be safer. However, we now know that is not the case,” says Barrett, who is also Chief of Maternal-Fetal Medicine at Sunnybrook Health Sciences Centre and Director of the Women & Babies Research Program at Sunnybrook Research Institute.

Additionally, the study found that those women who were randomized to planned cesarean sections delivered their babies earlier, something Barrett says should be avoided.

Dr. Barrett said he and his colleagues hope the findings of the Twin Birth Study will help decrease the rate of unnecessary cesarean sections. “I think these results will serve as a heads up to physicians to keep vaginal delivery skills in practice, so we don’t lose them,” he says.

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