Hospital elevator buttons carry more bacteria than toilet surfaces

Canadian study examines the hidden breeding ground for hospital infections

Hospital elevators are home to more bacteria than toilet surfaces--making the high-traffic area a breeding ground for potentially dangerous infections.

Canadian researchers at the University of Toronto found that bacteria commonly colonize on elevator buttons, although most pathogens were not clinically relevant, according to a study published in Open Medicine.

Researchers swabbed 120 elevator buttons and 96 toilet surfaces over separate intervals at three large, urban teaching hospitals on weekends and weekdays in Toronto, Ontario. They swabbed the up and down buttons on the outside of the elevator, along with the ground floor and a randomly selected upper-level floor button, while they swabbed the handles of the bathroom door, the privacy latch on the door and the toilet flusher.

There was a 61 percent prevalence of colonization on elevator buttons, which didn't vary based on location of the buttons, day of the week or panel position within the elevator, according to the study. Coagulase-negative staphylococci were the most common organism cultured, while Enterococcus and Pseudomonas species were infrequent. Toilet surfaces, on the other hand, only had a 43 percent prevalence of colonization.

Although absence of pathogenic organisms reflects good hand hygiene and staff cleaning, the prevalence of colonization shows patients remain at risk for cross contamination because of the frequent use of elevator buttons, according to the study.

Researcher noted that they took the samples during flu season, which could have influenced the bacteria count because of the increased use of hand sanitizer, or conversely, may have increased hospital traffic and generalized exposures.

The authors recommend alcohol-based hand sanitizers strategically placed inside and outside the elevators as a possible effective method for removing surface bacteria. Hospitals could also enlarge elevator buttons to allow for elbow activation, install touchless proximity sensors and increase public education about hand hygiene targeting individuals who use the elevators, according to the study.

Elevators aren't the only breeding ground for bacteria. The Society for Healthcare Epidemiology of America recommends new healthcare dress codes in order to reduce the spread of infections like C. diff and MRSA. Physicians should avoid wearing long sleeves, wristwatches, neckties and jewelry, and wear sturdy, closed-toed shoes, FierceHealthcare previously reported. Doctors should wash their white coats at least once a week in hot water and bleach, according to the article.

To learn more:
- here's the study

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