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Electronic Thermometers and Nosocomial Infections
- Lawrence L. Livornese Jr., MD;
- Matthew E. Levison, MD; and
- Caroline L. Johnson, MD
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•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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IN RESPONSE:
Mr. Bock and Dr. Abter and colleagues are correct in pointing out that electronic thermometers have previously been implicated as a vector for infectious disease. Brooks and colleagues [1] identified Clostridium difficile on 21% of electronic thermometers during a nosocomial outbreak of diarrhea as well as a decreased incidence of C. difficile-associated diarrhea after their replacement with single-use disposable thermometers. In our study, we identified vancomycin-resistant Enterococcus faecium on electronic rectal thermometers and a decreased incidence of infection and colonization after their removal [2]. The distinguishing feature of our study was the statistically significant association shown between exposure to electronic rectal thermometers and the acquisition of an infectious agent.
As for the treatment of vancomycin-resistant Enterococcus faecium, we used a combination of ciprofloxacin, rifampin, and gentamicin in our bacteremic patients on the basis of in vitro sensitivity data. Recent studies in a rat model have reproduced this effect [3], but we caution against generalizing these data to all vancomycin-resistant E. faecium because of the variable susceptibility of the organism to ciprofloxacin. Our outbreak was terminated by instituting contact isolation for all patients who were colonized or infected and by discontinuing the use of electronic rectal thermometers throughout our institution except for the emergency department and pediatric ward. We do not believe that broad recommendations about the use of electronic thermometers should be based on this outbreak alone. Further studies are necessary.
Lawrence L. Livornese Jr., MD
Matthew E. Levison, MD
Caroline L. Johnson, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
