Microbial Contamination on Elevator Buttons: A Three-Site Study in Tripoli Libya

Abstract

This study emphasizes the significance of surface hygiene and the impact of microbial contaminants on infections acquired in
healthcare settings and the community. Elevator buttons have been identified worldwide as high-risk surfaces that can harbor
bacteria, fungi, and, in certain instances, multidrug-resistant organisms.
This study aimed to examine microbial contamination on interior elevator buttons at different places such as clinics, hospitals,
and markets, at Tripoli, Libya, and to offer reference data for elevator disinfection and sanitation management to reduce
community-related infections.
A total of 20 elevator button samples were collected using sterile swabs and cultured on selective media including Blood Agar,
Mannitol Salt Agar, MacConkey Agar, and Sabouraud Dextrose Agar. Bacterial isolates were identified using the BD Phoenix™
system, while fungi were identified microscopically with Lactophenol Cotton Blue staining. Microbial growth was detected
across almost all sampled buttons, with variations between clinical and non-clinical settings.
Clinics showed both bacterial and fungal contamination on the surface of their elevators, while private clinics presented
predominantly bacterial growth. Market elevators displayed mixed contamination, with fungi dominating lower-floor buttons.
Identified bacteria included Staphylococcus epidermidis, Staphylococcus hominis, Acinetobacter baumannii, Pseudomonas
Pseudoalcaligenes, and Bacillus cereus, while fungal isolates included Aspergillus and Penicillium species. Several isolates
are known opportunistic pathogens and exhibit multi-drug resistance. It can be concluded that elevator buttons in Tripoli are
consistently contaminated with bacteria and fungi, including clinically significant resistant organisms, indicating that routine
cleaning alone is insufficient and improved infection control strategies are urgently needed