# A Pilot Metagenomic Study Demonstrating Virtual Reality Head Mounted Displays Utilized in Medical Education Are Reservoirs of Viable Pathogenic Microbes

## TL;DR

This study shows that VR headsets used in medical education can harbor harmful microbes, including drug-resistant bacteria, even after sanitation.

## Contribution

The study is the first to demonstrate that VR headsets can be reservoirs of viable pathogenic microbes in medical education settings.

## Key findings

- VR headsets had more microbes on surfaces near the eyes and facial interface than on external components.
- 27 pathogenic bacteria, including 4 ESKAPE pathogens, were identified on VR headsets.
- Antimicrobial resistance genes were found, showing resistance to multiple drug classes.

## Abstract

Virtual reality (VR) devices are increasingly being utilized within operating theaters and intensive care units where appropriate sanitation is vital to ensure that patients do not unnecessarily acquire hospital‐associated infections. The morphology of VR devices in conjunction with the variety of materials and internal components provides challenges to their repurposing. This study aimed to evaluate the microorganisms remaining on VR headsets following sanitation by laboratory staff in a medical education anatomy teaching facility. The external components and internal facial interface were swabbed and separately cultured on four AGAR plates (Horse Blood, Nutrient, bile Esculin, and Mannitol Salt). Colonies were counted, sampled, pooled and subsequently processed for shotgun metagenomic sequencing. A higher number of colonies were present on surfaces closest to the eyes and facial interface compared to the external components. Metagenomic analysis identified 27 pathogenic bacteria including 4 “ESKAPE” pathogens (Enterobacter sp., Staphylococcus aureus, Klebsiella spp. and, Escherichia coli) and numerous organisms associated with ocular infections. A broad range of antimicrobial resistance genes were identified conveying resistance to Methicillin, Aminoglycosides, Macrolides, Tetracyclines, and Polymixins. Further research is required to ensure that current sanitization practices of VR head mounted displays are appropriate within high‐risk hospital settings.

Metagenomic analysis identified 27 pathogenic bacteria including 4 "ESKAPE" pathogens (Enterobacter sp., Staphylococcus aureus, Klebsiella spp., and Escherichia coli) and numerous organisms associated with ocular infections. A broad range of antimicrobial resistance genes were identified conveying resistance to Methicillin, Aminoglycosides, Macrolides, Tetracyclines, and Polymixins.