Sharpie markers discovered to have potential use in hospitals

Even before their results have been published, researchers from the University of Alberta have created a craze around Sharpie markers and their potential for use at major hospitals with their simple, yet significant, study.

Dr Catherine Burton, a pediatrics infectious diseases resident, and Dr Sarah Forgie, a professor in the department of pediatrics at the U of A, collaborated to find the answer to a question that has never been posed previously: whether multiple use of a surgical marker leads to the spread of infectious microbes between patients.

“We found that Sharpies were quite safe to be used repeated numbers of time[s] even in the lab setting, [where] in ideal circumstances, [there are] much larger levels of inoculant organisms than you’d ever find on anybody’s skin. So using them in the real world is actually quite safe,” Burton explained.

Designed in response to an administrative decision that required the use of new markers for each patient undergoing surgery, Burton and Forgie took the initiative to examine whether this new procedure was really necessary. Forgie described that she first considered the issue seriously after a colleague surgeon Dr Bill Johnston, approached her.

“He asked me, ‘Do we really have to throw out the markers as we’d been advised to do?’ ” Forgie explained.

“I thought, ‘There’s no way an alcoholic nib [would allow] bacteria to survive.’ I couldn’t think of any reason why they would have to throw out the markers between patients,” she continued.

The research team examined two brands of markers—Sharpies and sterile surgical markers intended for single-use only—that are commonly used during surgery to mark operative sites. Deliberately contaminating the markers with one of four organisms, two of which were superbugs, they applied the marker nib to clean agar plates after recapping the pens and letting them sit for various time intervals. They then incubated these plates to examine resulting microbial growth.

“At any time period, even five minutes after [inoculation], the Sharpie markers showed essentially no growth. There was one out of 112 that actually showed any transfer of bacteria,” Burton explained.

“There was transfer of all of the organisms for multiple hours with the other brand of marker,” she added.

Burton believes that this difference in ability to resist contamination lies in the base used in the markers. Sharpie has an alcohol-based ink, which has antibacterial properties. The one-use surgical pens, on the other hand, use gentian violet ink with minimal antibacterial abilities.

However, additional steps still have to be taken after each surgical procedure to ensure that microbes aren’t transferred through contact with the body of the marker.

“The nibs will not transfer bacteria, but you have to clean the outside of the pen off with an alcohol swab, as you would with a stethoscope,” Forgie emphasized.

The results have gathered tremendous interest from those in the field of medicine. Burton’s abstract on the study was accepted for a major infectious disease conference held in Washington, DC, where she presented her results just last week.

“There was a lot of interest from a lot of different hospitals in the States. I had a lot of requests for copies of our results,” Burton explained.

In addition, the study has triggered changes in policies surrounding multiple marker use with Sharpies being adopted as the primary surgical pen. While not formally implemented yet, the policy encouraging multiple uses of Sharpies will be adopted by the Alberta health region and most likely by other centres in the United States.

“It’s going to have huge cost savings for the [University of Alberta] hospital. It’s going to have huge environmental savings because we’re not throwing out these pens. Plus, it’s going to be good for the patients because we’re not compromising their care at all in doing this,” Forgie explained.