Bacterial Colonization of Respiratory Therapists' Pens in the Intensive Care Unit

Prevention of nosocomial infections is of paramount importance. Person-to-person transmission of microorganisms is well recognized, but the role of fomites in nosocomial infection is not as well understood. Incomplete cleaning of equipment and patient rooms, and medical devices used with multiple patients are well-described means of transmission, but little attention has been paid to nonmedical devices as fomites. We collected bacteria from writing implements (pens) used by respiratory therapists in an intensive care unit, following their work shifts. We obtained pens from 20 respiratory therapists, and cultured, enumerated, and identified the bacteria. Bacteria were found on 17 of the 20 pens. The mean +/- SD number of colony-forming units was 126 +/- 277 (range 0-1,250). Coagulase-negative staphylococci were found on all 17 pens. Micrococcus species were found on 4 pens. Although we found no organisms that are regularly associated with nosocomial infections (eg, methicillin-resistant Staphylococcus aureus or Gram-negative bacilli), pens can be fomites responsible for nosocomial infections. Protocols to reduce the transmission of infectious agents may need to be extended to writing instruments. One possible measure is to assign specific writing instruments to specific rooms.