Metagenomic Analysis of Bacterial Diversity on Reusable Tourniquets in Hospital Environments

Background: Reusable tourniquets are commonly used to aid venipuncture and blood collection. However, inadequate disinfection may lead to bacterial contamination and increase the risk of healthcare-associated infections (HAIs). Tourniquets can function as fomites, facilitating the spread of pathogenic bacteria. This study assessed microbial contamination of reusable tourniquets in the emergency department and operating theatre, focusing on clinically relevant HAI-associated pathogens. Methods: Tourniquets from four hospital departments (emergency: adult observation and resuscitation; surgical theatres: pediatric and adult general surgery) were sampled at three time points (n = 12). DNA was extracted and analyzed via 16S rRNA sequencing using NGS technology to identify microbial contamination and taxonomic composition. Results: Sequencing revealed 131 bacterial species across the 12 tourniquets, including clinically important pathogens. Among the top ten HAI-associated groups, Klebsiella spp. were detected in 5/12 samples, Enterococcus spp. in 9/12, Staphylococcus aureus in 1/12, Pseudomonas aeruginosa in 9/12, and Acinetobacter spp. in 10/12. No Escherichia coli, Clostridium difficile, coagulase-negative staphylococci, Proteus spp., or Enterobacter spp. were found. Emergency department tourniquets showed higher bacterial loads; operating theatres had greater species diversity. Conclusions: Reusable tourniquets harbor significant bacterial contamination. Considering disinfection challenges and the lack of guidelines, single-use tourniquets should be considered to reduce HAI risk.