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Pathogen Transmission from Blood Pressure Cuffs

by Sandra Taber RN, BSN
Clinical Nurse Specialist
Murray State University
Department of Nursing

Introduction

      Decades of research has been conducted regarding the transmission of pathogens in hospitals from patient to patient, patient to staff, and staff into the community. Infectious diseases constitute the leading cause of death worldwide, and the third leading cause of death in the United States (Muto et al, 2003). As early as 1969 an Australian study identified the blood pressure cuff as a reservoir for bacteria, and that no other piece of hospital equipment was used more often without adequate disinfection (Beard, McIntyre, & Roundtree, 1969). Infection control programs were implemented three decades ago to help control the healthcare issue of antibiotic-resistance acquired infections and the spread of these infections. The Society for Healthcare Epidemiology of America appointed a taskforce to define evidence- based guideline for preventing pathogen transmission with a focus on Methicillin Resistant Staphlococcus Aureus (MRSA) and Vancomycin Resistant Enterococcus (VRE) (Muto et al, 2003). 

      The Centers for Disease Control (CDC) have estimated that more than 2 million people per year acquire a hospital (nosocomial) related infection every year. CDC statistics state that the cost of treating these infections is $4.5 billion annually with mortality rates between 60,000 to 80,000 patients (CDC Recommendations and Report# 5005a1, 2001). Higher risk patients include the neonate or the patient in the Intensive Care Unit, Coronary Care Unit, surgery, or renal dialysis patients (de Gialluly, et.al, 2006, Myers 1978, Base-Smith, 1996, Baruah et al, 2008).

Content

      Blood pressure cuffs have been found to be a major source of cross contamination between patients. A study by Webb (2002) using cultures taken from blood pressure cuffs found MRSA on 9% of the cuffs. A blood pressure cuff sleeve was then applied on these same cuffs and cultures were repeated at the end of the day. No MRSA was found on the cuffs after a barrier was used. Thirteen years ago Manian, Meyer, & Jenne (1996) reported a study that revealed contamination of blood pressure cuffs with Clostridium difficile (C diff) at levels that were the same as bedside commodes (10%). More recently Gupta, Walker, and Cheesbrough (2006) assessed the level of contamination of blood pressure cuffs used in hospital wards. Twenty four cuffs had viable organisms, eleven of these cuffs grew a single organism and three grew a mixture of organisms. All together there were 18 organisms isolated from the 24 cuffs: Methicillin Sensitive Staphlococcus Aeurus (MSSA) from 8 cuffs, MRSA from 2 cuffs, and C-Diff was found on 8 cuffs. Ellis (2008) identified blood pressure cuffs as a major environmental source for cross contamination.

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