Bacterial contamination of patients' medical charts in a surgical ward and the intensive care unit: Impact on nosocomial infections

Background and purpose: The purpose of this study was to determine the degree of bacterial contamination of patients' files, and to compare the colonized bacteria between files from the surgical intensive care unit (ICU) and the surgical ward at the Wan Fang Hospital, Taipei, Taiwan. Methods: 180 medical charts were randomly selected from the surgical ICU (n = 90) and the surgical ward (n = 90). The charts were sampled using sterile swabs moistened with sterile normal saline. The swabs were immediately transferred to trypticase soy broth and incubated aerobically for 48 h, then subcultured to separated sheep blood and eosin-methylene blue agars. Microorganisms were identified by the standard methods used in the microbiological laboratory. Results: Ninety percent of charts in the surgical ICU (n = 81) and 72.2% in the surgical ward (n = 65) were contaminated with pathogenic or potentially pathogenic bacteria (p = 0.0023). Coagulase-negative staphylococci (CoNS) were the most commonly isolated bacteria, both in the surgical ICU (n = 40, 44.44%) and in the surgical ward (n = 48, 53.33%). Several bacteria isolated from the charts, including multidrug-resistant Acinetobacter bauman- nii, Stenotrophomonas maltophilia, and Klebsiella pneumoniae, had the same antibiogram as the same bacteria isolated from patients. Conclusion: This study showed that the patients' charts in the ICU were usually contaminated with pathogenic and potentially pathogenic bacteria. Contaminated charts can serve as a source for cross-infection. Health care personnel should wash their hands before and after contact with the chart to reduce the nosocomial infection rate.