Contamination of Stethoscopes and Physicians’ Hands After a Physical Examination

February 24, 2017 at 3:50 pm

Mayo Clinic Proceedings February 2014 V.89 N.2  P.291–299

Yves Longtin, Alexis Schneider, Clément Tschopp, Gesuèle Renzi, Angèle Gayet-Ageron, Jacques Schrenzel, Didier Pittet

Abstract

Objectives

To compare the contamination level of physicians’ hands and stethoscopes and to explore the risk of cross-transmission of microorganisms through the use of stethoscopes.

Patients and Methods

We conducted a structured prospective study between January 1, 2009, and May 31, 2009, involving 83 inpatients at a Swiss university teaching hospital. After a standardized physical examination, 4 regions of the physician’s gloved or ungloved dominant hand and 2 sections of the stethoscopes were pressed onto selective and nonselective media; 489 surfaces were sampled. Total aerobic colony counts (ACCs) and total methicillin-resistant Staphylococcus aureus (MRSA) colony-forming unit (CFU) counts were assessed.

Results

Median total ACCs (interquartile range) for fingertips, thenar eminence, hypothenar eminence, hand dorsum, stethoscope diaphragm, and tube were 467, 37, 34, 8, 89, and 18, respectively. The contamination level of the diaphragm was lower than the contamination level of the fingertips (P<.001) but higher than the contamination level of the thenar eminence (P=.004). The MRSA contamination level of the diaphragm was higher than the MRSA contamination level of the thenar eminence (7 CFUs/25 cm2 vs 4 CFUs/25 cm2; P=.004). The correlation analysis for both total ACCs and MRSA CFU counts revealed that the contamination level of the diaphragm was associated with the contamination level of the fingertips (Spearman’s rank correlation coefficient, ρ=0.80; P<.001 and ρ=0.76; P<.001, respectively). Similarly, the contamination level of the stethoscope tube increased with the increase in the contamination level of the fingertips for both total ACCs and MRSA CFU counts (ρ=0.56; P<.001 and ρ=.59; P<.001, respectively).

Conclusion

These results suggest that the contamination level of the stethoscope is substantial after a single physical examination and comparable to the contamination of parts of the physician’s dominant hand.

PDF

http://www.mayoclinicproceedings.org/article/S0025-6196(13)01084-7/pdf

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Entry filed under: Bacterias, Biología Molecular, Desinfection and Sterilization, Epidemiología, Health Care-Associated Infections, Infecciones nosocomiales, Metodos diagnosticos, Resistencia bacteriana, Update.

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