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More than just teddy bears: Unconventional transmission agents in the operating room.

Abstract

INTRODUCTION

Surgical site infection (SSI) following orthopedic surgery can have a substantial impact on patients and families. The rate remains high, ranging from 0.5% to 8.5% in pediatric spine surgery. It is common to allow children to bring a teddy bear (or similar toy) to the surgical ward to help reduce the stress of surgery. We hypothesize that despite their known benefits for children, teddies would increase the bacterial load in the surgical room.

METHODS

A blinded descriptive study was conducted from June 2015 to September 2016. The study included children entering the hospital through the emergency ward for a traumatic cause requiring surgery. Patients admitted for infectious problems and those who had been hospitalized less than 6 months before the inclusion date were excluded. A picture of the teddy was taken and stored in a blind fashion. The AFNOR (Association française de normalisation) standardized rules for bacteriological surface control and the ISO/DIS 14698 protocol were strictly followed. Two independent observers performed blind bacteriologic analyses of the teddy bears with bacteria identification and colony counts. Photos of the teddy bears were then analyzed by two blinded, independent observers: one doctor and one parent from outside the hospital. Cleanliness and fluffiness of the toy was evaluated using a numeric scale.

RESULTS

Bacteria were identified on 100% of the 53 teddies included. The mean number of bacteria was 182.5±49.8 CFU/25 cm2. Eight teddies (15.1%) tested positive for potential pathogenic bacteria (two staphylococcus aureus, one acinetobacter ursingii, four acinetobacter baumannii, one pseudomonas stutzeri). Three teddies (5.7%) tested positive for fungi. The median cleanliness score was 2 (interquartile range (IQR)=1) if rated by the doctor and 2 (IQR=1) if rated by the parent. No statistical difference was found between these two values in the global teddy bear population. We found no any statistical link between the number of CFUs and the cleanliness scores given by the doctor. The median fluffiness score given by the parent was 2 (IQR=1). Looking at the correlative CFUs, we found a statistically significant difference between each stage of fluffiness with a higher stage showing higher CFU (P<0.0001).

CONCLUSION

Despite their documented benefits for the child, teddy bears are not appropriate in the surgical room.

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  • Authors+Show Affiliations

    ,

    Department of Paediatric Orthopaedics, Pierre and Marie-Curie University Paris 6, Armand-Trousseau Hospital, 26, avenue du Dr Arnold-Netter, 75571 Paris cedex 12, France. Electronic address: Alexandre.hardy@me.com.

    ,

    Department of Paediatric Orthopaedics, Pierre and Marie-Curie University Paris 6, Armand-Trousseau Hospital, 26, avenue du Dr Arnold-Netter, 75571 Paris cedex 12, France.

    ,

    Department of Paediatric Orthopaedics, Pierre and Marie-Curie University Paris 6, Armand-Trousseau Hospital, 26, avenue du Dr Arnold-Netter, 75571 Paris cedex 12, France.

    ,

    Interventional Unit for Hospital Hygiene, Pierre and Marie-Curie University Paris 6, Armand-Trousseau Hospital, 26, avenue du Dr Arnold-Netter, 75571 Paris cedex 12, France.

    ,

    Microbiology Department, Pierre and Marie-Curie University Paris 6, Saint-Antoine hospital, rue du Faubourg-Saint-Antoine, 75011 Paris, France.

    Department of Paediatric Orthopaedics, Pierre and Marie-Curie University Paris 6, Armand-Trousseau Hospital, 26, avenue du Dr Arnold-Netter, 75571 Paris cedex 12, France; Department for Innovative Therapies in Musculoskeletal Diseases, The MAMUTH Hospital-University, Armand-Trousseau Hospital, 26, avenue du Dr Arnold-Netter, 75571 Paris cedex 12, France.

    Source

    MeSH

    Adolescent
    Bacteria
    Bacteriological Techniques
    Child
    Child, Preschool
    Cross Infection
    Female
    Humans
    Infant
    Male
    Operating Rooms
    Play and Playthings
    Surgical Wound Infection

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    30220524

    Citation

    Hardy, A, et al. "More Than Just Teddy Bears: Unconventional Transmission Agents in the Operating Room." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 25, no. 7, 2018, pp. 416-420.
    Hardy A, Sabatier V, Rosello O, et al. More than just teddy bears: Unconventional transmission agents in the operating room. Arch Pediatr. 2018;25(7):416-420.
    Hardy, A., Sabatier, V., Rosello, O., Salauze, B., Barbut, F., & Vialle, R. (2018). More than just teddy bears: Unconventional transmission agents in the operating room. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 25(7), pp. 416-420. doi:10.1016/j.arcped.2018.08.003.
    Hardy A, et al. More Than Just Teddy Bears: Unconventional Transmission Agents in the Operating Room. Arch Pediatr. 2018;25(7):416-420. PubMed PMID: 30220524.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - More than just teddy bears: Unconventional transmission agents in the operating room. AU - Hardy,A, AU - Sabatier,V, AU - Rosello,O, AU - Salauze,B, AU - Barbut,F, AU - Vialle,R, Y1 - 2018/09/13/ PY - 2018/01/28/received PY - 2018/05/11/revised PY - 2018/08/15/accepted PY - 2018/9/18/pubmed PY - 2018/12/12/medline PY - 2018/9/18/entrez KW - Fomite KW - Infection KW - Nosocomial infections KW - Pediatrics KW - Plush KW - Teddy bear KW - Toys SP - 416 EP - 420 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 25 IS - 7 N2 - INTRODUCTION: Surgical site infection (SSI) following orthopedic surgery can have a substantial impact on patients and families. The rate remains high, ranging from 0.5% to 8.5% in pediatric spine surgery. It is common to allow children to bring a teddy bear (or similar toy) to the surgical ward to help reduce the stress of surgery. We hypothesize that despite their known benefits for children, teddies would increase the bacterial load in the surgical room. METHODS: A blinded descriptive study was conducted from June 2015 to September 2016. The study included children entering the hospital through the emergency ward for a traumatic cause requiring surgery. Patients admitted for infectious problems and those who had been hospitalized less than 6 months before the inclusion date were excluded. A picture of the teddy was taken and stored in a blind fashion. The AFNOR (Association française de normalisation) standardized rules for bacteriological surface control and the ISO/DIS 14698 protocol were strictly followed. Two independent observers performed blind bacteriologic analyses of the teddy bears with bacteria identification and colony counts. Photos of the teddy bears were then analyzed by two blinded, independent observers: one doctor and one parent from outside the hospital. Cleanliness and fluffiness of the toy was evaluated using a numeric scale. RESULTS: Bacteria were identified on 100% of the 53 teddies included. The mean number of bacteria was 182.5±49.8 CFU/25 cm2. Eight teddies (15.1%) tested positive for potential pathogenic bacteria (two staphylococcus aureus, one acinetobacter ursingii, four acinetobacter baumannii, one pseudomonas stutzeri). Three teddies (5.7%) tested positive for fungi. The median cleanliness score was 2 (interquartile range (IQR)=1) if rated by the doctor and 2 (IQR=1) if rated by the parent. No statistical difference was found between these two values in the global teddy bear population. We found no any statistical link between the number of CFUs and the cleanliness scores given by the doctor. The median fluffiness score given by the parent was 2 (IQR=1). Looking at the correlative CFUs, we found a statistically significant difference between each stage of fluffiness with a higher stage showing higher CFU (P<0.0001). CONCLUSION: Despite their documented benefits for the child, teddy bears are not appropriate in the surgical room. SN - 1769-664X UR - https://www.unboundmedicine.com/medline/citation/30220524/More_than_just_teddy_bears:_Unconventional_transmission_agents_in_the_operating_room L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(18)30172-6 DB - PRIME DP - Unbound Medicine ER -