By Monika Pogorzelska-Maziarz, PhD, MPH, College of Nursing, Thomas Jefferson University, Philadelphia, PA
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BACKGROUND
- Sharps disposal containers are ubiquitous in healthcare facilities.
- However, there is paucity of data on the potential for environmental contamination of these containers and their role in transmission of pathogens.
- The potential for sharps containers to become a source of pathogen transmission within the healthcare setting is an issue that has been raised1,2 but not systematically studied.
- This is especially important given that contamination of the hospital environment has been shown to be an important component of pathogen transmission.
OBJECTIVES
- To describe the use of different types of sharps containers in a national sample of hospitals.
- To assess the relationship between the use of reusable vs. single-use sharps containers and rates of C. difficile infections.
METHODS
- Cross-sectional survey of 2,056 hospitals with ≥100 beds conducted in December 2013 to collect data on the use of sharps disposal containers.
- Survey linked to 2012 Medicare Provider Analysis and Review (MedPAR) dataset containing facility characteristics and C. difficile infection rates as identified by ICD-9 codes.
- Differences in C. difficile infection rates between hospitals using reusable vs. single-use sharps containers examined using bivariate and multivariable negative binomial regression models.
FINANCIAL SUPPORT AND CONFLICT OF INTEREST
Support for this study was provided by Becton, Dickinson and Company. MPM served as a consultant to Becton, Dickinson and Company on this project
RESULTS
- Completed surveys received from 604 hospitals (30% response rate).
- 539 hospitals provided data on the type of sharps containers used in Fiscal Year 2012 (27% response rate).
- Participating hospitals were predominantly non-for-profit (67%) and non-teaching (63%).
- The majority of respondents reported their primary role was in environmental safety (56%); a third were infection preventionists (31%).
- The majority of hospital utilized reusable sharps containers (72%) in FY 2012.
- Use of single-use vs. reusable sharps containers differed significantly by region, bedsize, ownership, annual discharges and urbanicity (p-values <0.05).
- In bivariate regression, hospitals using single use sharps containers had significantly lower rates of C. difficile infections vs. hospitals using reusable sharps containers (Incidence Rate Ratio [IRR] = 0.846, p-value = 0.001).
- This relationship persisted in multivariable regression (IRR = 0.870, p-value = 0.003] after controlling for other hospital characteristics.
CONCLUSIONS
- This is the first study to show a link between the use of single-use sharps containers and lower C. difficile infection rates and further work is needed to replicate this finding.
- Future studies should investigate the potential for environmental contamination of reusable sharps disposal containers with C. difficile and other micro-organisms and the role that sharps containers may play in pathogen transmission.
REFERENCES
1.Neely AN, Maley MP, Taylor GL. Investigation of single-use versus reusable infectious waste containers as potential sources of microbial contamination. Am J Infect Control 2003; 31:12-7.
2.Runner JC. Bacterial and viral contamination of reusable sharps containers in a community hospital setting. Am J Infect Control 2007; 35:527-30.
