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CORRESPONDENCE |
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Year : 2013 | Volume
: 31
| Issue : 3 | Page : 320-321 |
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Hand-held hazards by health-care workers
P Datta, N Bansal, J Chander
Department of Microbiology, Government Medical College Hospital, Chandigarh, India
Date of Submission | 08-May-2013 |
Date of Acceptance | 31-May-2013 |
Date of Web Publication | 25-Jul-2013 |
Correspondence Address: P Datta Department of Microbiology, Government Medical College Hospital, Chandigarh India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0255-0857.115675
How to cite this article: Datta P, Bansal N, Chander J. Hand-held hazards by health-care workers. Indian J Med Microbiol 2013;31:320-1 |
Dear Editor,
Health-care workers (HCWs) accessories like stethoscope, mobile and pen have become important fomites in spread of health-care infections (HAI). Personal equipment used at patient's point of care may be responsible for cross-transmission and these represent an important risk for hospitalized patients. Over 30 years back, stethoscopes had being identified as potential vector for HAI as they come onto direct contact with patient's skin. [1] To further increase this complexity, mobiles of HCWs showed 9-25% contamination with pathogenic bacteria, methicillin resistant Staphylococcus aureus (MRSA) and Acinetobacter spp. being the most common. [2]
We designed a preliminary study aimed to determine the microbial contamination rates of randomly selected stethoscopes. Also, the relationship between stethoscope contamination, stethoscope cleaning practices and mobile contamination was assessed.
This prospective surveillance study was carried out at a tertiary care centre with randomly selected HCWs including physicians, interns and nursing staff from various areas of the hospital. The surface of the diaphragm of each participant's stethoscope and their respective mobiles were swabbed with sterile cotton tipped swab sticks, moistened in sterile normal saline. The swabs were then transported to Department of Microbiology and the isolates were identified according to standard microbiological criteria. Isolates identified as S. aureus were further tested for MRSA using 30 μg cefoxitin as per Clinical Standards Laboratory Institute guidelines.
A total of 80 HCWs were enrolled in the study. A total of 21 stethoscopes and 19 mobiles were found colonized. All positive samples yielded S. aureus (n = 40), out of which 50% were MRSA. No Gram-negative bacilli or coagulase-negative Staphylococci were isolated. Cleaning practices of stethoscope correlated with contamination on stethoscope as shown in [Table 1]. | Table 1: Rate of colonization of stethoscope, mobile and cleaning practices
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Uneke et al., and Pandey et al., found S. aureus to be the most common pathogen (54% and 27.5%, respectively) as compared to other bacteria isolated from stethoscope and other accessories of the doctor. [3],[4] Additionally, 16 out of 80 HCWs (20%) who had stethoscope colonization also had colonization on their MRSA. This important fact could be linked to presence of MRSA on the hands of these workers thereby spreading to both mobiles and stethoscope. The absence of Gram-negative bacteria, from mobiles of our health-care setup, has been previously documented. [5]
Eradication of bacteria from equipment is considered a vital part of infection control practices. Simple steps of hand washing (My 5 moments of hand hygiene, World Health Organization) before, after and in between patients are pivotal for good hospital infection practices. The importance of cleaning stethoscope and mobile daily cannot be re-emphasized.
~ References | |  |
1. | Whittington AM, Whitlow G, Hewson D, Thomas C, Brett SJ. Bacterial contamination of stethoscopes on the intensive care unit. Anaesthesia 2009;64:620-4.  [PUBMED] |
2. | Tacconelli E. When did the doctors become fomites? Clin Microbiol Infect 2011;17:794-6.  [PUBMED] |
3. | Uneke CJ, Ogbonna A, Oyibo PG, Onu CM. Bacterial contamination of stethoscopes used by health workers: Public health implications. J Infect Dev Ctries 2010;4:436-41.  [PUBMED] |
4. | Pandey A, Asthana AK, Tiwari R, Kumar L, Das A, Madan M. Physician accessories: Doctor, what you carry is every patient's worry? Indian J Pathol Microbiol 2010;53:711-3.  [PUBMED] |
5. | Datta P, Rani H, Chander J, Gupta V. Bacterial contamination of mobile phones of health care workers. Indian J Med Microbiol 2009;27:279-81.  [PUBMED] |
[Table 1]
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