Brief Report
The role of chiropractic adjusting tables as reservoirs for microbial diseases

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Background

Our goal was to enumerate the microbial flora on the headrest, armrest, and thoracic portion of chiropractic adjusting tables to determine the presence of pathogenic microorganisms and identify the potential for nosocomial transmission.

Methods

Defined portions of the headrest, armrest, and thoracoabdominal pieces from 9 chiropractic adjusting tables were randomly sampled using the ACT II culture transport system (Remel, Lenexa, KS). Samples were incubated using standard culture techniques for bacteriology and mycology that included 15 mL of heart infusion agar at 35°C for 24 hours and 15 mL of Sabouraud dextrose agar at 30°C up to 7 days.

Results

Identification of microorganisms by biochemical analysis yielded a wide variety of gram-positive (G+) and gram-negative (G−) cocci and bacilli as well as standard fungi. Many were of the genus Staphylococcus. Methicillin-resistant S. aureus (MRSA) isolates were recovered from 2 separate tables.

Conclusion

This study supports a growing consensus that those outpatient facilities that do not adhere to strict infection control protocols may become ecological reservoirs of potentially harmful human pathogens.

Section snippets

Sampling

Nine chiropractic adjusting tables from the National University outpatient clinic were randomly selected using a lottery and sampled using the ACT II culture transport system (Remel, Lenexa, KS). We opted to run the samples after the clinics' normal hours of operation so that no patients, interns, or clinicians would be conscious of the study and change their normal habits. Briefly, a 4 × 4-inch area of the leather and metallic components of the head, arm, thoracic, and abdominal pieces were

Results

Our results indicate that those surfaces that come into contact with patients' integument do harbor many organisms, including coagulase-positive staphylococci and gram-negative bacilli (Table 1). Two of these isolates in particular were methicillin-resistant Staphylococcus aureus (MRSA). Other commonly encountered isolates included nonpathogenic environmental fungi representing the species Cladosporium spp, Candida, Penicillium, and Rhodotorula rubra. The number of fungal colony-forming units

Discussion

A majority of the isolates recovered were of the family Micrococcaceae. The two isolates of MRSA is a significant cause of concern. Although these organisms usually cause mild superficial skin infections, they can progress to life-threatening systemic infections that are very difficult to treat. In fact, MRSA is emerging as an important cause of community-acquired skin and soft tissue infections.9 Although most of the isolated microorganisms are ubiquitous in the environment and pose no serious

Conclusions

All of the surfaces sampled on the chiropractic adjusting tables carried microorganisms. Most of these were harmless skin bacteria or environmental fungi. Some of the surfaces did harbor S. aureus, a human pathogen. Some of these strains of Staphylococcus were MRSA. Armrests and uncovered portions of headrests had the highest bacterial counts. The disinfection protocols must therefore address removal of staphylococci from these surfaces to prevent horizontal transmission in the outpatient

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