Reusable Electroencephalography Electrodes: Variability in Cleaning and Reprocessing Practices

Of 124 reusable electroencephalography cup electrodes/lead wires from four epilepsy monitoring units, 25% had bacterial growth. Institutional cleaning practices of electroencephalography cup electrode lead wires may contribute to positive culture prevalence. In this study, personnel who supervised cleaning of electroencephalography cup electrodes/lead wires completed an investigator-developed survey. Generalized mixed-effect models compared sites, including storage area within site as a random effect, to adjust for correlation between wires stored in the same location. Odds ratios and 95% confidence intervals were calculated. Of nine characteristics (transportation time, wait time pre-cleaning, storage pre-cleaning [covered or not covered], disinfection time, cleaning time, bundled cleaning [always, frequently, or occasionally], drying practice [towel or air], drying time, and storage post-cleaning [covered or not covered]), when drying time was less than or equal to 5 minutes, there was a 71% decrease in the odds of positive bacterial cultures (odds ratio [95% confidence interval]: 0.29 [0.09, 0.97], P = 0.045). Further, when cleaning time was not rushed (greater than 1 hour after removal from patient care) and multiple sets of electroencephalography cup electrodes were cleaned at once, there was a trend toward fewer positive bacterial cultures (odds ratios [95% confidence intervals] for both factors: 0.16 [0.02, 1.40], P = 0.092). Microorganisms were found on cleaned electroencephalography cup electrode lead wires in each of four hospital-based epilepsy monitoring units, despite cleaning practices. When cleaning and reprocessing practice characteristics were assessed, site variation was high, and some cleaning practices were associated with higher rates of positive bacterial cultures.