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Predictors of Heavy Stethoscope Contamination Following a Physical Examination

Published online by Cambridge University Press:  08 March 2016

Clément Tschopp ,
Alexis Schneider ,
Yves Longtin ,
Gesuele Renzi ,
Jacques Schrenzel  and
Didier Pittet
Clément Tschopp
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Alexis Schneider
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Yves Longtin
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Gesuele Renzi
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Jacques Schrenzel
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Didier Pittet*
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland WORLD HEALTH ORGANIZATION Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
*
Address correspondence to Didier Pittet, MD, MS, Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Gabrielle-Perret-Gentil 4, 1211 Geneve-14, Switzerland ([email protected]).
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Abstract

BACKGROUND

The degree of bacterial contamination of stethoscopes can vary significantly following a physical examination.

OBJECTIVE

To conduct a prospective study to investigate the impact of various environmental and patient characteristics on stethoscope contamination.

METHODS

Following a standardized examination, the levels of bacterial contamination of 4 regions of the physicians’ hands and 2 sections of the stethoscopes, and the presence of different pathogenic bacteria, were assessed. Predictors of heavy stethoscope contamination were identified through multivariate logistic regression.

RESULTS

In total, 392 surfaces were sampled following examination of 56 patients. The microorganisms most frequently recovered from hands and stethoscopes were Enterococcus spp. (29% and 20%, respectively) and Enterobacteriaceae (16% and 7%, respectively). Staphylococcus aureus (either methicillin susceptible or resistant), extended-spectrum β-lactamase–producing Enterobacteriaceae, and Acinetobacter baumannii were recovered from 4%-9% of the samples from either hands or stethoscopes. There was a correlation between the likelihood of recovering these pathogens from the stethoscopes vs from the physicians’ hands (ρ=0.79; P=.04). The level of patient’s skin contamination was an independent predictor of contamination of the stethoscope diaphragm (adjusted odds ratio [aOR], 1.001; P=.007) and tube (aOR, 1.001; P=.003). Male sex (aOR, 28.24; P=.01) and reception of a bed bath (aOR, 7.52; P=.048) were also independently associated with heavy tube contamination.

CONCLUSIONS

Stethoscope contamination following a single physical examination is not negligible and is associated with the level of contamination of the patient’s skin. Prevention of pathogen dissemination is needed.

Infect Control Hosp Epidemiol 2016;37:673–679

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 6 , June 2016 , pp. 673 - 679
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

(Present affiliation: Jewish General Hospital and McGill University Faculty of Medicine, Montreal, Canada [Y.L.])

References

REFERENCES

1. Pittet, D, Allegranzi, B, Sax, H, et al. Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641–652.CrossRefGoogle ScholarPubMed
2. World Health Organization (WHO). WHO guidelines on hand hygiene in health care. WHO website. http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf. Published 2009.Google Scholar
3. Allegranzi, B, Gayet-Ageron, A, Damani, N, et al. Global implementation of WHO’s multimodal strategy for improvement of hand hygiene: a quasi-experimental study. Lancet Infect Dis 2013;13:843–851.Google Scholar
4. Luangasanatip, N, Hongsuwan, M, Limmathurotsakul, D, et al. Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. BMJ 2015;351:h3728.Google Scholar
5. Nunez, S, Moreno, A, Green, K, Villar, J. The stethoscope in the emergency department: a vector of infection? Epidemiol Infect 2000;124:233–237.Google Scholar
6. Longtin, Y, Schneider, A, Tschopp, C, et al. Contamination of stethoscopes and physicians’ hands after a physical examination. Mayo Clin Proc 2014;89:291–299.CrossRefGoogle ScholarPubMed
7. Pittet, D, Hugonnet, S, Harbarth, S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 2000;356:1307–1312.Google Scholar
8. Raad, I, Hanna, H, Maki, D. Intravascular catheter-related infections: advances in diagnosis, prevention, and management. Lancet Infect Dis 2007;7:645–657.Google Scholar
9. Francois, P, Pittet, D, Bento, M, et al. Rapid detection of methicillin-resistant Staphylococcus aureus directly from sterile or nonsterile clinical samples by a new molecular assay. J Clin Microbiol 2003;41:254–260.Google Scholar
10. Matsuo, M, Oie, S, Furukawa, H. Contamination of blood pressure cuffs by methicillin-resistant Staphylococcus aureus and preventive measures. Ir J Med Sci 2013;182:707–709.CrossRefGoogle ScholarPubMed
11. Lestari, T, Ryll, S, Kramer, A. Microbial contamination of manually reprocessed, ready to use ECG lead wire in intensive care units. GMS Hyg Infect Control 2013;8:Doc07.Google ScholarPubMed
12. Tadiparthi, S, Shokrollahi, K, Juma, A, Croall, J. Using marker pens on patients: a potential source of cross infection with MRSA. Ann R Coll Surg Engl 2007;89:661–664.CrossRefGoogle ScholarPubMed
13. Whitehead, EJ, Thompson, JF, Lewis, DR. Contamination and decontamination of Doppler probes. Ann R Coll Surg Engl 2006;88:479–481.CrossRefGoogle ScholarPubMed
14. Vernon, MO, Hayden, MK, Trick, WE, Hayes, RA, Blom, DW, Weinstein, RA. Chlorhexidine gluconate to cleanse patients in a medical intensive care unit: the effectiveness of source control to reduce the bioburden of vancomycin-resistant enterococci. Arch Intern Med 2006;166:306–312.CrossRefGoogle Scholar
15. Grice, EA, Kong, HH, Conlan, S, et al. Topographical and temporal diversity of the human skin microbiome. Science 2009;324:1190–1192.Google Scholar
16. Callewaert, C, Kerckhof, FM, Granitsiotis, MS, Van Gele, M, Van de Wiele, T, Boon, N. Characterization of Staphylococcus and Corynebacterium clusters in the human axillary region. PLoS One 2013;8:e70538.CrossRefGoogle ScholarPubMed
17. Lingaas, E, Fagernes, M. Development of a method to measure bacterial transfer from hands. J Hosp Infect 2009;72:43–49.Google Scholar
18. Vajravelu, RK, Guerrero, DM, Jury, LA, Donskey, CJ. Evaluation of stethoscopes as vectors of Clostridium difficile and methicillin-resistant Staphylococcus aureus . Infect Control Hosp Epidemiol 2012;33:96–98.Google Scholar