1100. Utility of Reflective Surface Markers for the Assessment of Personnel Contamination during Removal of Personal Protective Equipment
Session: Poster Abstract Session: Infection Prevention: Hand Hygiene and PPE
Friday, October 9, 2015
Room: Poster Hall
Background: Bacteriophage MS2 is a non-pathogenic, non-enveloped RNA virus used to study spread of pathogens. However, use of this organism requires microbiological expertise and does not provide direct visualization of contamination that can be used to provide feedback. Fluorescent lotions or powders have previously been used to simulate contamination with pathogens, including transfer to skin and clothing during PPE removal. We hypothesized that a reflective surface marker (RSM, 3M) visible after flash photography would be similarly effective for evaluation of personnel contamination during removal of contaminated personal protective equipment (PPE).

Methods: After volunteers donned PPE (gowns and nitrile gloves), a mixture of RSM and bacteriophage MS2 was applied to gloved hands. After removal of PPE, hands and forearms were assessed for RSM contamination using a digital camera and then sampled for the presence and concentration of bacteriophage MS2 by culture.

Results: Of 50 simulations performed, 16(32%) resulted in contamination with bacteriophage and RSM, 5 (10%) with MS2 alone, and 8 (16%) with RSM alone. Mean bacteriophage recovery for contaminated simulations was 0.74 ± 0.9 log10 plaque-forming units (PFU) (95% CI 0.49-1.0). There was no significant difference in the percent contamination with RSM and bacteriophage MS2 (48% vs 42%, p=0.69).

Conclusion: The frequency of contamination of the hands and forearms of healthcare personnel during protective equipment removal was similar for reflective surface marker and bacteriophage MS2. Our results suggest that reflective surface markers can be used as a simple and rapid tool to simulate contamination with pathogens and document personnel contamination during PPE training.

Figure 1. 2x2 Table Comparing Bacteriophage MS2 and Reflective Marker (RSM) Contamination

Bacteriophage MS2 Contamination




Reflective Surface Marker (RSM) Contamination













Myreen Tomas, MD1, Jennifer Cadnum, B.S.2,3, Thriveen S.C. Mana, MS2, Sirisha Kundrapu, MD2,3, Venkata Sunkesula, MD2,3, Annette Jencson, BS, MT, CIC3 and Curtis J. Donskey, MD1,2, (1)Geriatric Research Education and Clinical Centers, Cleveland VA Medical Center, Cleveland, OH, (2)Case Western Reserve University, Cleveland, OH, (3)Research Service, Cleveland VA Medical Center, Cleveland, OH


M. Tomas, None

J. Cadnum, None

T. S. C. Mana, None

S. Kundrapu, None

V. Sunkesula, None

A. Jencson, None

C. J. Donskey, 3M: Scientific Advisor , Research grant

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.