Nasopharyngeal Temperature Probes: Is South Africa's Current Decontamination Process Adequate?

Abstract

Background: The standard practice in many institutions incorporates nasopharyngeal probes for temperature monitoring in patients undergoing  general anaesthesia. Current disinfection guidelines for these devices are not clear and they are poorly adhered to. In South Africa, these  temperature probes are reused and subjected to unstandardized decontamination processes. This study sought to investigate the nasopharyngeal temperature probe as a possible source of cross-contamination and investigate the efficacy of current disinfection practices.
Method: This descriptive double-blind study viewed 48 nasopharyngeal temperature probe cultures across the 4 different cleaning protocols. These  probes were randomized to a disinfection protocol. These protocols included water wash, alcohol based wash, dry wipe and (2.4% glutaraldehyde)  Cidex® wash. After randomization, the probes were aseptically cultured and inoculated to blood agar plates. After 48hrs of aerobic culture,  specimens were examined, and microorganisms identified. Logistic regression analysis assessed the efficacy of these decontamination processes. Results: Chi-Square analysis [p-value < 0,0001] established the nasopharyngeal temperature probe as a source of crosscontamination. Diverse  pathogens were identified on nasopharyngeal temperature probes after exposure to a predetermined cleaning practice.Logistic regression of these  cleaning methods [confidence interval of 95%] illustrates Hibitane® and CIDEX® methods as being more effective, yet only the CIDEX® group  demonstrated decontamination success in excess of 90%. Commonly identified organisms include Staphylococcus aureus, Streptococcus epidermis;  Pseudomonas aeruginosa and Acinetobacter baumanii.
Conclusion: The data shows that the nasopharyngeal temperature probe is indeed a source of cross-contamination. It goes on to highlight the issue  of pathogenic spread due to inadequate decontamination of these temperature probes.