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Yoo JY, Oh S, Shalish W, Maeng WY, Cerier E, Jeanne E, Chung MK, Lv S, Wu Y, Yoo S, Tzavelis A, Trueb J, Park M, Jeong H, Okunzuwa E, Smilkova S, Kim G, Kim J, Chung G, Park Y, Banks A, Xu S, Sant'Anna GM, Weese-Mayer DE, Bharat A, Rogers JA. Wireless broadband acousto-mechanical sensing system for continuous physiological monitoring. Nat Med 2023; 29:3137-3148. [PMID: 37973946 DOI: 10.1038/s41591-023-02637-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/06/2023] [Indexed: 11/19/2023]
Abstract
The human body generates various forms of subtle, broadband acousto-mechanical signals that contain information on cardiorespiratory and gastrointestinal health with potential application for continuous physiological monitoring. Existing device options, ranging from digital stethoscopes to inertial measurement units, offer useful capabilities but have disadvantages such as restricted measurement locations that prevent continuous, longitudinal tracking and that constrain their use to controlled environments. Here we present a wireless, broadband acousto-mechanical sensing network that circumvents these limitations and provides information on processes including slow movements within the body, digestive activity, respiratory sounds and cardiac cycles, all with clinical grade accuracy and independent of artifacts from ambient sounds. This system can also perform spatiotemporal mapping of the dynamics of gastrointestinal processes and airflow into and out of the lungs. To demonstrate the capabilities of this system we used it to monitor constrained respiratory airflow and intestinal motility in neonates in the neonatal intensive care unit (n = 15), and to assess regional lung function in patients undergoing thoracic surgery (n = 55). This broadband acousto-mechanical sensing system holds the potential to help mitigate cardiorespiratory instability and manage disease progression in patients through continuous monitoring of physiological signals, in both the clinical and nonclinical setting.
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Affiliation(s)
- Jae-Young Yoo
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Seyong Oh
- Division of Electrical Engineering, Hanyang University ERICA, Ansan, Republic of Korea
| | - Wissam Shalish
- Neonatal Division, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | - Woo-Youl Maeng
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Emily Cerier
- Division of Thoracic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emily Jeanne
- Neonatal Division, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | - Myung-Kun Chung
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Shasha Lv
- Neonatal Division, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | - Yunyun Wu
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Seonggwang Yoo
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Andreas Tzavelis
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Jacob Trueb
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Minsu Park
- Department of Polymer Science and Engineering, Dankook University, Yongin, Republic of Korea
| | - Hyoyoung Jeong
- Department of Electrical and Computer Engineering, University of California, Davis, CA, USA
| | - Efe Okunzuwa
- Division of Thoracic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Slobodanka Smilkova
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, USA
| | - Gyeongwu Kim
- Adlai E. Stevenson High School, Lincolnshire, IL, USA
| | - Junha Kim
- Department of Advanced Materials Engineering for Information and Electronics, Kyung Hee University, Gyeonggi-do, Republic of Korea
| | - Gooyoon Chung
- Department of Advanced Materials Engineering for Information and Electronics, Kyung Hee University, Gyeonggi-do, Republic of Korea
| | - Yoonseok Park
- Department of Advanced Materials Engineering for Information and Electronics, Kyung Hee University, Gyeonggi-do, Republic of Korea
| | - Anthony Banks
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
| | - Shuai Xu
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA
- Sibel Health, Niles, IL, USA
| | - Guilherme M Sant'Anna
- Neonatal Division, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada
| | - Debra E Weese-Mayer
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Autonomic Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Ankit Bharat
- Division of Thoracic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - John A Rogers
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.
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Dressler RL, Cruser B, Dressler DD. Hospital Physicians’ Stethoscopes: Bacterial Contamination After a Simple Cleaning Protocol. Cureus 2023; 15:e37061. [PMID: 37153267 PMCID: PMC10155595 DOI: 10.7759/cureus.37061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Stethoscope surfaces become contaminated with bacteria due to inconsistent cleaning practices, as cleaning frequency and practical cleansing approaches are not well-established. METHODS We investigated bacterial contamination of stethoscopes at baseline, after simple cleaning, and after examining one patient. We surveyed 30 hospital providers on stethoscope cleaning practices and then measured bacterial contamination of stethoscope diaphragm surfaces before cleaning, after cleaning with alcohol-based hand sanitizer, and after use in examining one patient. RESULTS Only 20% of providers reported cleaning stethoscopes regularly. Before cleaning, 50% of stethoscopes were contaminated with bacteria, compared with 0% after cleaning (p<0.001) and 36.7% after examining one patient (p=0.002). Among providers who reported not cleaning stethoscopes regularly, 58% had bacterial-contaminated stethoscopes compared with 17% who did report cleaning regularly (p=0.068). CONCLUSIONS Hospital providers' stethoscopes had a high probability of bacterial contamination at baseline and after examining one patient. We recommend decontamination with alcohol-based hand sanitizer immediately before each patient examination.
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Barrett RE, Fleiss N, Hansen C, Campbell MM, Rychalsky M, Murdzek C, Krechevsky K, Abbott M, Allegra T, Blazevich B, Dunphy L, Fox A, Gambardella T, Garcia L, Grimm N, Scoffone A, Bizzarro MJ, Murray TS. Reducing MRSA Infection in a New NICU During the COVID-19 Pandemic. Pediatrics 2023; 151:190449. [PMID: 36625072 DOI: 10.1542/peds.2022-057033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Methicillin-resistant Staphylococcus aureus (MRSA) is prevalent in most NICUs, with a high rate of skin colonization and subsequent invasive infections among hospitalized neonates. The effectiveness of interventions designed to reduce MRSA infection in the NICU during the coronavirus disease 2019 (COVID-19) pandemic has not been characterized. METHODS Using the Institute for Healthcare Improvement's Model for Improvement, we implemented several process-based infection prevention strategies to reduce invasive MRSA infections at our level IV NICU over 24 months. The outcome measure of invasive MRSA infections was tracked monthly utilizing control charts. Process measures focused on environmental disinfection and hospital personnel hygiene were also tracked monthly. The COVID-19 pandemic was an unexpected variable during the implementation of our project. The pandemic led to restricted visitation and heightened staff awareness of the importance of hand hygiene and proper use of personal protective equipment, as well as supply chain shortages, which may have influenced our outcome measure. RESULTS Invasive MRSA infections were reduced from 0.131 to 0 per 1000 patient days during the initiative. This positive shift was sustained for 30 months, along with a delayed decrease in MRSA colonization rates. Several policy and practice changes regarding personnel hygiene and environmental cleaning likely contributed to this reduction. CONCLUSIONS Implementation of a multidisciplinary quality improvement initiative aimed at infection prevention strategies led to a significant decrease in invasive MRSA infections in the setting of the COVID-19 pandemic.
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Affiliation(s)
| | - Noa Fleiss
- Yale School of Medicine, New Haven, Connecticut
| | | | | | | | | | | | - Meaghan Abbott
- Yale New Haven Children's Hospital, New Haven, Connecticut
| | - Terese Allegra
- Yale New Haven Children's Hospital, New Haven, Connecticut
| | - Beth Blazevich
- Yale New Haven Children's Hospital, New Haven, Connecticut
| | - Louise Dunphy
- Yale New Haven Children's Hospital, New Haven, Connecticut
| | - Amy Fox
- Yale New Haven Children's Hospital, New Haven, Connecticut
| | | | - Lindsey Garcia
- Yale New Haven Children's Hospital, New Haven, Connecticut
| | - Natalie Grimm
- Yale New Haven Children's Hospital, New Haven, Connecticut
| | - Amy Scoffone
- Yale New Haven Children's Hospital, New Haven, Connecticut
| | | | - Thomas S Murray
- Yale School of Medicine, New Haven, Connecticut.,Yale New Haven Children's Hospital, New Haven, Connecticut
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Peacock WF, Chemaly RF, Torriani F, Shahid Z, Dawal S. A new normal for the clinician's third hand: Stethoscope hygiene and infection prevention. Am J Infect Control 2023; 51:114-118. [PMID: 36351475 DOI: 10.1016/j.ajic.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/09/2022]
Affiliation(s)
- W Frank Peacock
- Research Henry JN Taub Department of Emergency Medicine Baylor College of Medicine, Houston, TX.
| | - Roy F Chemaly
- Clinical Virology Research Department of ID/IC/EH UT MD, Anderson Cancer Center, Houston, TX; Division of Epidemiology, Human Genetics, and Environmental Sciences, UT School of Public Health, Houston, TX; Medicine Baylor College of Medicine, Houston, TX
| | - Francesca Torriani
- Infection Prevention and Clinical Epidemiology and Tuberculosis Control UC San Diego Health, Clinical Division of ID And Global Health at UC San Diego San Diego, CA
| | - Zainab Shahid
- Memorial Sloan Kettering Cancer Center, Manhattan, NY
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Discordance among Belief, Practice, and the Literature in Infection Prevention in the NICU. CHILDREN 2022; 9:children9040492. [PMID: 35455536 PMCID: PMC9027430 DOI: 10.3390/children9040492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022]
Abstract
This study evaluates practices of infection control in the NICU as compared with the available literature. We aimed to assess providers’ awareness of their institutional policies, how strongly they believed in those policies, the correlation between institution size and policies adopted, years of experience and belief in a policy’s efficacy, and methods employed in the existing literature. An IRB-approved survey was distributed to members of the AAP Neonatal Section. A systematic review of the literature provided the domains of the survey questions. Data was analyzed as appropriate. A total of 364 providers responded. While larger NICUs were more likely to have policies, their providers are less likely to know them. When a policy is in place and it is known, providers believe in the effectiveness of that policy suggesting consensus or, at its worst, groupthink. Ultimately, practice across the US is non-uniform and policies are not always consistent with best available literature. The strength of available literature is adequate enough to provide grade B recommendations in many aspects of infection prevention. A more standardized approach to infection prevention in the NICU would be beneficial and is needed.
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Mills JP, Marchaim D. Multidrug-Resistant Gram-Negative Bacteria: Infection Prevention and Control Update. Infect Dis Clin North Am 2021; 35:969-994. [PMID: 34752228 DOI: 10.1016/j.idc.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Multidrug-resistant gram-negative bacteria (MDR-GNB) pose one of the greatest challenges to health care today because of their propensity for human-to-human transmission and lack of therapeutic options. Containing the spread of MDR-GNB is challenging, and the application of multifaceted infection control bundles during an evolving outbreak makes it difficult to measure the relative impact of each measure. This article will review the utility of various infection control measures in containing the spread of various MDR-GNB and will provide the supporting evidence for these interventions.
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Affiliation(s)
- John P Mills
- Division of Infectious Diseases, University of Michigan Medical School, F4177 University Hospital South, 1500 E. Medical Center Dr, Ann Arbor, MI 48109-5226, USA.
| | - Dror Marchaim
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Division of Infectious Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
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Study to Assess the Risk of Transmission of Microbial Organisms and their Resistance Pattern on Dresses and Stethoscopes of Health Care Workers. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.3.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The main objective of the study was to find out the contamination of different types of microbial organisms and their resistance pattern on the dresses and stethoscopes of the health care workers in order to evaluate the risk of transmission of microbial organisms and its consequences on safety of the patient and control of hospital acquired infections (HAIs). Swabs were taken from the dresses of 100 different healthcare workers from 4 different areas namely collar, pocket, sleeves and sides and 100 stethoscopes (diaphragm) were tested for bacteriological analysis using standard techniques. Then each health care worker were given a structured questionnaire and requested to fill the form which includes his or her speciality/unit, cadre, practice of hand hygiene, white-coat or uniform usage (Example: duration of usage, frequency of washing, type of washing etc). The collar and pockets were found to be the most contaminated areas. Gram-positive cocci such as Staphylococcus aureus and Coagulase-negative Staphylococci (CONS) were the important organisms isolated from the dresses and stethoscopes of health care workers followed by Gram-negative bacilli such as Pseudomonas aeruginosa and Klebsiella species. Among the microbial organisms, Staphylococcus aureus and CONS were resistant to the drugs like Co-trimoxazole and Penicillin-G. Organisms isolated from the dresses and stethoscopes of health care workers could be a source of infection to immunocompromised patients. Hence, frequent washing of the dresses and strict disinfectant practices of the stethoscopes will minimize the contamination with microbial organisms and the patient safety is improved in the hospital environment.
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Sahiledengle B, Tekalegn Y, Bekele K, Tesemma A, Edward Quisido BJ. Disinfection of Stethoscope and Non-Infrared Thermometer: Practices of Physicians in Ethiopia in the Era of COVID-19. Risk Manag Healthc Policy 2021; 13:3245-3257. [PMID: 33447105 PMCID: PMC7802342 DOI: 10.2147/rmhp.s289125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/23/2020] [Indexed: 01/09/2023] Open
Abstract
Background Stethoscopes and non-infrared thermometers are the customary medical equipment used by the physicians on a daily basis, among various patients. With the rise of potential infections in the healthcare facilities and the transmission nature of the current COVID-19 pandemic, consistent and correct disinfections of these devices after each use should not be pardoned. This study, therefore, aimed to assess the level of stethoscope and non-infrared thermometer disinfection practices among physicians involved in direct patient contact during the COVID-19 pandemic. Methods A web-based cross-sectional survey was conducted among physicians working in Ethiopia to assess their practice of stethoscope and non-infrared thermometer disinfection. The online survey was circulated using an anonymous and self-reporting questionnaire via Google form with a consent form appended to it. The developed Google form link was shared with physicians through their email addresses and social media pages. A descriptive summary was computed and presented by tables and figures. Multivariable logistic regression model was used to identify factors associated stethoscope and non-infrared thermometer after every use. Results The proportion of stethoscope and non-infrared thermometer disinfections after every use was 13.9% (95% CI: 10.9–17.6) and 20.4% (95% CI: 16.7–24.5), respectively. Taking COVID-19 training (AOR: 2.52; 95% CI: 1.29–4.92) and the availability of stethoscope disinfection materials at the workplace (AOR: 3.03; 95% CI: 1.29–7.10) were significantly increased the odds of stethoscope disinfection after every use. The odds of stethoscope disinfection after every use was significantly decreased for those who reported the use of shared stethoscope (AOR: 0.34; 95% CI: 0.12–0.92). Conclusion Only a wee share of the respondents reported that they have disinfected their stethoscopes and non-infrared thermometers after every use – possibly jeopardizing both patients and clinicians safety, particularly during the COVID-19 pandemic.
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Affiliation(s)
- Biniyam Sahiledengle
- Madda Walabu University Goba Referral Hospital, School of Health Sciences, Public Health Department, Goba, Bale, Ethiopia
| | - Yohannes Tekalegn
- Madda Walabu University Goba Referral Hospital, School of Health Sciences, Public Health Department, Goba, Bale, Ethiopia
| | - Kebebe Bekele
- Madda Walabu University Goba Referral Hospital, Department of Surgery, Goba, Bale, Ethiopia
| | - Abdi Tesemma
- Madda Walabu University Goba Referral Hospital, Department of Surgery, Goba, Bale, Ethiopia
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Darge A, Kahsay AG, Hailekiros H, Niguse S, Abdulkader M. Bacterial contamination and antimicrobial susceptibility patterns of intensive care units medical equipment and inanimate surfaces at Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia. BMC Res Notes 2019; 12:621. [PMID: 31547851 PMCID: PMC6757422 DOI: 10.1186/s13104-019-4658-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/18/2019] [Indexed: 11/10/2022] Open
Abstract
Objective To determine bacterial contaminants and their antimicrobial susceptibility patterns from medical equipment and inanimate surfaces. Results Of 130 swabs, 115 (88.5%) swabs were culture positive, of which contaminated medical equipment and inanimate surfaces account 70 (83.3%) and 45 (97.8%), respectively. All the swabs collected from sphygmomanometer, bedside table, computer and computer standing tables were 100% contaminated with bacteria. From the culture-positive swabs, a total of 171 bacterial isolates were identified, out of which 117 (68.4%) and 54 (31.6%) isolates were gram-positive and gram-negative, respectively. Most isolates (82%) were resistant to ampicillin and 13%, 8.6%, and 14% was observed in ciprofloxacin, gentamicin, and tetracycline respectively. Multi-drug resistant was observed in Escherichia coli (72.7%) and Staphylococcus aureus (58.7%).
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Affiliation(s)
- Addis Darge
- Medical Laboratory Technology Department, Bahirdar College of Health Sciences, Bahidar, Ethiopia
| | - Atsebaha Gebrekidan Kahsay
- Medical Microbiology and Immunology Unit, Institute of Biomedical Sciences, College of Health Science, Mekelle University, PO. Box: 1871, Mekelle, Ethiopia.
| | - Haftamu Hailekiros
- Medical Microbiology and Immunology Unit, Institute of Biomedical Sciences, College of Health Science, Mekelle University, PO. Box: 1871, Mekelle, Ethiopia
| | - Selam Niguse
- Medical Microbiology and Immunology Unit, Institute of Biomedical Sciences, College of Health Science, Mekelle University, PO. Box: 1871, Mekelle, Ethiopia
| | - Mahmud Abdulkader
- Medical Microbiology and Immunology Unit, Institute of Biomedical Sciences, College of Health Science, Mekelle University, PO. Box: 1871, Mekelle, Ethiopia
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Stethoscope disinfection is rarely done in Ethiopia: What are the associated factors? PLoS One 2019; 14:e0208365. [PMID: 31246946 PMCID: PMC6597050 DOI: 10.1371/journal.pone.0208365] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 06/12/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction The stethoscope, which is non-critical medical devices and a symbol of healthcare, is likely to be contaminated by pathogenic microorganisms and can play a contributory role in the transmission of hospital-acquired infection. And regular cleaning of the diaphragm of the stethoscope with a suitable disinfectant is decisive. However, in the resource-constrained setting like many healthcare facilities in Ethiopia healthcare provider’s stethoscope disinfection practice and its associated factors have not been well studied so far. Therefore, this study sought to determine stethoscope disinfection practice and associated factors among the healthcare providers in Addis Ababa, Ethiopia. Methods A facility-based cross-sectional study was carried out between April and May 2016. For this study, 576 healthcare providers (physicians, health officers, nurses, midwives, and anesthesiologist) were included from 21 healthcare facilities in Addis Ababa. A pre-tested structured questionnaire was used for data collection. Descriptive statistics were computed. Bivariate and multivariable logistic regression analyses were used to identify factors that were significantly associated with stethoscope disinfection after every use. Results A total of 546 healthcare providers participated in this study, for a response rate of 94.7%. Two-fifths, 39.7% (95%CI: 35.9, 44.0%) of healthcare providers disinfecting their stethoscope after every use. And a significant number of participants 34.6% (95%CI: 30.8, 38.5%) never disinfect their stethoscope. Three out of four (76.0%) healthcare providers believe that stethoscope contamination can contribute to the transmission of infections. Safe infection prevention practice (AOR = 3.79, 95%CI: 2.45–5.84), awareness on infection prevention guideline (AOR = 1.93; 95%CI: 1.31, 2.82), and favorable attitude towards infection prevention (AOR = 1.73, 95%CI: 1.02, 2.93) were significantly associated with stethoscope disinfection after every use. The study also found that the odds of stethoscope disinfection were likely to be reduced by 79% among physicians than nurses (AOR = 0.21; 95%CI: 0.09, 0.49). Conclusions Only a small proportion of healthcare providers disinfect their stethoscopes after every use. Factors such as safe infection prevention practice, awareness on infection prevention guidelines, and favorable attitude towards infection prevention were the independent predictors of stethoscopes disinfection after every use. Hence, promotion of stethoscope hygiene along with an educational program to enhance disinfection compliance in healthcare facilities may have a positive effect.
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Alfarawi F, Alshamardl K, Almutairi M, Alyamani A, Aldhali S, Alassaf F, Alfadhel A, Aldakheel M, Almuhesseny A, Aljohani S, Mahmoud E, Alothman A. Can identification badges be vectors of infection: Experience from a tertiary care center in Riyadh, Saudi Arabia. J Family Med Prim Care 2019; 8:1599-1601. [PMID: 31198721 PMCID: PMC6559097 DOI: 10.4103/jfmpc.jfmpc_173_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Wearing identification badges is mandatory in many hospitals. Identification badges worn by healthcare workers may be contaminated with pathogens. Objective: The objective of this study is to determine the levels and types of contamination on identification badges of healthcare workers at King Abdulaziz Medical City in Riyadh, Saudi Arabia. Materials and Methods: This is a cross-sectional study of 200 healthcare workers at King Abdulaziz Medical City in Riyadh, Saudi Arabia. A data collection form was handed to all the participants and swab cultures of their identification badges were taken. Results: A total of 200 identification badges were sampled in this study. 37% were contaminated with pathogens. Coagulase-negative Staphylococcus was isolated from 70 badges (35%), and methicillin-sensitive Staphylococcus aureus from four badges (2%). Contamination was highest in physicians (45% compared to 14–32% in other healthcare workers). Males and females had similar contamination rates (39 and 36%, respectively). Conclusion: Identification badges worn by healthcare workers may be vectors of significant infection. We suggest more compliance of infection control measures in regards to disinfecting badges or personal belongings of healthcare workers.
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Affiliation(s)
- Fahad Alfarawi
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Alshamardl
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Muhammad Almutairi
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Alwaleed Alyamani
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Saif Aldhali
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Faisal Alassaf
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Abdulmajeed Alfadhel
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Msab Aldakheel
- Department of Medicine, Dar Al Uloom University, Riyadh, Kingdom of Saudi Arabia
| | - Ali Almuhesseny
- Department of Medicine, Majmaah University, Al Majmaah, Kingdom of Saudi Arabia
| | - Sameera Aljohani
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Ebrahim Mahmoud
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Adel Alothman
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City in Riyadh, Riyadh, Kingdom of Saudi Arabia
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Weldegebreal F, Admassu D, Meaza D, Asfaw M. Non-critical healthcare tools as a potential source of healthcare-acquired bacterial infections in eastern Ethiopia: A hospital-based cross-sectional study. SAGE Open Med 2019; 7:2050312118822627. [PMID: 30693084 PMCID: PMC6317151 DOI: 10.1177/2050312118822627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 12/11/2018] [Indexed: 12/02/2022] Open
Abstract
Background: Outbreaks of healthcare-acquired infections have been linked to contaminated medical devices such as electronic thermometers, sphygmomanometers, stethoscopes, latex gloves, masks, neckties, white coats and other. Objective: The aim of this study was to assess non-critical healthcare tools as a potential source of healthcare-acquired bacterial infections and associated factors in public health hospitals of Harar, eastern Ethiopia from March 2016 to February 2017. Methods: A hospital-based cross-sectional study was conducted on 212 non-critical healthcare tools owned by different health professionals. The data were collected from each owner using self-administered questionnaire. Swab specimens were collected from 187 stethoscopes and 25 sphygmomanometers using sterile cotton tips. Bacterial investigation and antimicrobial susceptibility tests were performed using standard culture tests. The data were double entered into EPI-Data version 3.1 and exported into the Statistical Package for Social Sciences version 16 for analysis. Result: The overall prevalence of non-critical healthcare tool contamination was 53.8%. A total of 137 bacterial strains were isolated. Staphylococcus aureus was the most frequent isolate (35%). Resistance to two or more different classes of antimicrobial was found to be 19.3%. The proportion of stethoscopes or sphygmomanometers contamination owned by the health professionals who were not cleaned regularly before and after examining each patient was found to be high (77%). The majority of non-critical healthcare tools used by health professionals working in the intensive care unit were contaminated (75%) followed by medical wards (73.5%). Conclusion: This study confirmed that the majority of the stethoscopes and sphygmomanometers were contaminated with pathogenic bacteria known to be associated with healthcare-acquired infections. Most of the healthcare workers did not practice stethoscope and sphygmomanometers disinfection. Strict and careful decontamination of stethoscopes and sphygmomanometers need to be in place before use.
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Affiliation(s)
- Fitsum Weldegebreal
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Desalegn Admassu
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dereje Meaza
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mulatu Asfaw
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Horiuchi Y, Wettersten N, Vasudevan RS, Barnett O, Maisel AS. Stethoscope as a Vector for Infectious Disease. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2018. [DOI: 10.1007/s40138-018-0167-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lin D, Ou Q, Lin J, Peng Y, Yao Z. A meta-analysis of the rates of Staphylococcus aureus and methicillin-resistant S aureus contamination on the surfaces of environmental objects that health care workers frequently touch. Am J Infect Control 2017; 45:421-429. [PMID: 28010909 DOI: 10.1016/j.ajic.2016.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/10/2016] [Accepted: 11/10/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Health care workers may potentially spread Staphylococcus aureus and methicillin-resistant S aureus (MRSA) to patients by contaminated high-touch items. We aimed to determine the pooled rates of S aureus and MRSA contamination and influencing factors. METHODS A literature search of the PubMed, ScienceDirect, Embase, Ovid, and Scopus databases was performed. Pooled contamination rates were determined using random effect models. Subgroup and meta-regression analyses were conducted to identify factors potentially influencing the rates of S aureus and MRSA contamination. Sensitivity and publication bias analyses were performed. RESULTS Thirty-eight studies were included in the meta-analysis. The pooled contamination rates were 15.0% (95% confidence interval [CI], 9.8%-21.1%) for S aureus and 5.0% (95% CI, 2.7%-7.7%) for MRSA. The subgroup analyses indicated that the pooled rate of S aureus contamination was significantly higher for studies conducted in South America, in developing countries, and during 2010-2015. The pooled rate of MRSA contamination was significantly higher for studies conducted in Africa. The meta-regression analysis suggested that the pooled rate of S aureus contamination was lower for studies conducted in developed countries (odds ratio, 0.664; 95% CI, 0.509-0.867; P = .004). No bias was found in the publication of the rates of S aureus and MRSA contamination. CONCLUSIONS S aureus and MRSA contamination statuses of high-touch items are worrisome and should be paid greater attention. Developing country status was a risk factor for S aureus contamination.
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Bramstedt KA, Colaco CMG, De Silva E, Rehfield PL, Blumenthal-Barby JS. Perceptions of US and Australian Medical Students and Instructors About Clinical Professional Attire: LAPEL Study. J Osteopath Med 2017; 116:244-54. [PMID: 27018959 DOI: 10.7556/jaoa.2016.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT White coats have long been the professional uniform of physicians. However, when physicians opt to remove the white coat, their clothing underneath is brought to the forefront and can influence how they are perceived by their patients. OBJECTIVE To explore the perceptions of medical students and their instructors about appropriate clinical professional attire. METHODS An anonymous, voluntary 55-question survey was electronically distributed to medical students and their instructors at 2 US and 2 Australian medical schools. The survey incorporated 30 images of sample attire, 9 demographic questions, and 16 questions regarding culture and context of clothing and accessories. RESULTS In total, 411 students and 73 instructors participated in this study. The data revealed that white coats and neckties are nearly absent in Australian clinical attire. Overall, students were significantly more supportive of full facial coverage due to religious or cultural values compared with instructors (P<.001), and US medical students were significantly more supportive than Australian students (P<.001). All cohorts preferred dress code policies that directed students to avoid but not prohibit the use of perfume or cologne. Nose rings were controversial with significantly more support for use from medical students than instructors (pooled cohorts, P=.002). Medical students in both the United States and Australia indicated that they were most influenced by observing the attire of physicians at work (155 [38%]), compared with courses in medical ethics (19 [5%]), school policy (16 [4%]), or hospital policy (9 [2%]). CONCLUSION Although regional dress code practices are different in the United States compared with Australia, medical students were overall most influenced by their instructors' attire in clinical settings.
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Adler A, Friedman ND, Marchaim D. Multidrug-Resistant Gram-Negative Bacilli: Infection Control Implications. Infect Dis Clin North Am 2016; 30:967-997. [PMID: 27660090 DOI: 10.1016/j.idc.2016.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Antimicrobial resistance is a common iatrogenic complication of both modern life and medical care. Certain multidrug resistant and extensively drug resistant Gram-negative organisms pose the biggest challenges to health care today, predominantly owing to a lack of therapeutic options. Containing the spread of these organisms is challenging, and in reality, the application of multiple control measures during an evolving outbreak makes it difficult to measure the relative impact of each measure. This article reviews the usefulness of various infection control measures in containing the spread of multidrug-resistant Gram-negative bacilli.
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Affiliation(s)
- Amos Adler
- Clinical Microbiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Medicine, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Dror Marchaim
- Department of Medicine, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Division of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin 70300, Israel.
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Healthcare Personnel Attire and Devices as Fomites: A Systematic Review. Infect Control Hosp Epidemiol 2016; 37:1367-1373. [PMID: 27609491 DOI: 10.1017/ice.2016.192] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Transmission of pathogens within the hospital environment remains a hazard for hospitalized patients. Healthcare personnel clothing and devices carried by them may harbor pathogens and contribute to the risk of pathogen transmission. OBJECTIVE To examine bacterial contamination of healthcare personnel attire and commonly used devices. METHODS Systematic review. RESULTS Of 1,175 studies screened, 72 individual studies assessed contamination of a variety of items, including white coats, neckties, stethoscopes, and mobile electronic devices, with varied pathogens including Staphylococcus aureus, including methicillin-resistant S. aureus, gram-negative rods, and enterococci. Contamination rates varied significantly across studies and by device but in general ranged from 0 to 32% for methicillin-resistant S. aureus and gram-negative rods. Enterococcus was a less common contaminant. Few studies explicitly evaluated for the presence of Clostridium difficile. Sampling and microbiologic techniques varied significantly across studies. Four studies evaluated for possible connection between healthcare personnel contaminants and clinical isolates with no unequivocally direct link identified. CONCLUSIONS Further studies to explore the relationship between healthcare personnel attire and devices and clinical infection are needed. Infect Control Hosp Epidemiol 2016;1-7.
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Grif Alspach J. About that health care icon dangling around your neck: do we have some cleaning up to do? Crit Care Nurse 2015; 34:11-4. [PMID: 24882825 DOI: 10.4037/ccn2014437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Infektionsprävention im Rahmen der Pflege und Behandlung von Patienten mit übertragbaren Krankheiten. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 58:1151-70. [DOI: 10.1007/s00103-015-2234-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Tang PH, Worster A, Srigley JA, Main CL. Examination of staphylococcal stethoscope contamination in the emergency department (pilot) study (EXSSCITED pilot study). CAN J EMERG MED 2015; 13:239-44. [DOI: 10.2310/8000.2011.110242] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
ABSTRACT
Introduction:
The objective of this study was to determine the prevalence of Staphylococcus-contaminated stethoscopes belonging to emergency department (ED) staff and to identify the proportion of these that were Staphylococcus aureus or methicillin-resistant Staphylococcus aureus (MRSA).
Methods:
We conducted a prospective observational cohort study of bacterial cultures from 100 ED staff members' stethoscopes at three EDs. Study participants were asked to complete a questionnaire.
Results:
Fifty-four specimens grew coagulase-negative staphylococci and one grew methicillin-susceptible S. aureus. No MRSA was cultured. Only 8% of participants, all of whom were nurses, reported cleaning their stethoscope before or after each patient assessment. Alcohol-based wipes were most commonly used to clean stethoscopes. A lack of time, being too busy, and forgetfulness were the most frequently reported reasons for not cleaning the stethoscope in the ED.
Conclusions:
This study indicates that although stethoscope contamination rates in these EDs are high, the prevalence of S. aureus or MRSA on stethoscopes is low.
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O'Flaherty N, Fenelon L. The stethoscope and healthcare-associated infection: a snake in the grass or innocent bystander? J Hosp Infect 2015; 91:1-7. [PMID: 26092471 DOI: 10.1016/j.jhin.2015.04.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/06/2015] [Indexed: 12/28/2022]
Abstract
There is a concern that stethoscopes may transmit infectious agents which could result in healthcare-associated infection (HCAI). The aim of this review was to evaluate the available literature as to the role of the stethoscope in the development of HCAI. A literature search was conducted across several databases for relevant studies and reports. Stethoscopes were consistently shown to harbour bacteria. The mean rate of stethoscope contamination across 28 studies was 85% (range: 47-100%). The majority of bacteria isolated were deemed to be non-pathogenic. The most frequently isolated organisms were coagulase-negative staphylococci. The mean level of contamination was in excess of the French Normalization standard for cleanliness (which equates to <20 colony-forming units per membrane) in all six studies in which contamination levels were quantified. Potentially pathogenic organisms cultured from stethoscopes included: Staphylococcus aureus, Pseudomonas aeruginosa, vancomycin-resistant enterococci, and Clostridium difficile. There was evidence that bacteria can transfer from the skin of the patient to the stethoscope and from the stethoscope to the skin. However, studies were not designed to detect a correlation between stethoscope contamination and subsequent HCAI. Surveys assessing cleaning practices revealed a suboptimal commitment to stethoscope disinfection among doctors and medical students. The optimum method for stethoscope cleaning has not been defined, although alcohol-based disinfectants are effective in reducing bacterial contamination. In conclusion, a link between contaminated stethoscopes and HCAI has not yet been confirmed, but transfer of bacteria between skin and stethoscope has been shown. The available information would suggest that stethoscopes should be decontaminated between patients.
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Affiliation(s)
- N O'Flaherty
- St Vincent's University Hospital, Dublin, Ireland.
| | - L Fenelon
- St Vincent's University Hospital, Dublin, Ireland
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Affiliation(s)
- R A Stein
- Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, NY, USA. ,
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Longtin Y, Schneider A, Tschopp C, Renzi G, Gayet-Ageron A, Schrenzel J, Pittet D. Contamination of stethoscopes and physicians' hands after a physical examination. Mayo Clin Proc 2014; 89:291-9. [PMID: 24582188 DOI: 10.1016/j.mayocp.2013.11.016] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/05/2013] [Accepted: 11/14/2013] [Indexed: 11/29/2022]
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 cm(2) vs 4 CFUs/25 cm(2); 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.
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Affiliation(s)
- Yves Longtin
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexis Schneider
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Clément Tschopp
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Gesuèle Renzi
- Bacteriology Laboratory and Genomic Research Laboratory, University of Geneva Hospitals, Geneva, Switzerland
| | - Angèle Gayet-Ageron
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jacques Schrenzel
- Bacteriology Laboratory and Genomic Research Laboratory, University of Geneva Hospitals, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Shiferaw T, Beyene G, Kassa T, Sewunet T. Bacterial contamination, bacterial profile and antimicrobial susceptibility pattern of isolates from stethoscopes at Jimma University Specialized Hospital. Ann Clin Microbiol Antimicrob 2013; 12:39. [PMID: 24330702 PMCID: PMC3880102 DOI: 10.1186/1476-0711-12-39] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 12/08/2013] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Hospital acquired infections are recognized as critical public health problems. Infections are frequently caused by organisms residing in healthcare environment, including contaminated medical equipment like Stethoscopes. OBJECTIVE To determine bacterial contamination, bacterial profile and anti-microbial susceptibility pattern of the isolates from stethoscopes at Jimma University Specialized Hospital. METHODOLOGY Cross-sectional study conducted from May to September 2011 at Jimma University Specialized Hospital. One hundred seventy-six stethoscopes owned by Health Care Workers (HCWs) and Medical students were randomly selected and studied. Self-administered structured questionnaire was used to collect socio-demographic data. Specimen was collected using moisten sterile cotton swab and 1 ml normal saline was used to transport the specimen, all laboratory investigations were done following standard microbiological techniques, at Microbiology Laboratory, Jimma University. SPSS windows version 16 used for data analysis and P <0.05 was considered statistically significant. RESULT A total, of 151 (85.8%) stethoscopes were contaminated. A total of 256 bacterial strains and a mean of 1.44×104 CFUs/diaphragm of stethoscopes was isolated. Of the 256 isolates, 133 (52%) were potential pathogens like S. aureus, Klebsiella spp., Citrobacter spp., Salmonella spp., Proteus spp., Enterobacter spp., P. aeruginosa and E. coli. All strains were resistant to multiple classes of antibiotics (two to eight classes of antibiotics). Disinfection practice was poor. Disinfection practice was found to be associated with bacterial contamination of stethoscopes (P < 0.05). High contamination rate 100 (90.9%) was observed among stethoscopes that had never been disinfected; while the least contamination 29 (72.2%) was found on those disinfected a week or less before the survey. CONCLUSION Bacterial contamination of the stethoscope was significant. The isolates were potential pathogens and resistant to multiple classes of antibiotics. Stethoscope is potential vehicle in the transmission of infections between patients and Healthcare Workers. Stethoscope diaphragm should be disinfected before and after each patient contact.
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Affiliation(s)
- Teklu Shiferaw
- Department of microbiology, Adama hospital medical college, Adama, P.o. box-84, Ethiopia
| | - Getenet Beyene
- Department of Laboratory Science and Pathology, Jimma University, Jimma, Po.box -378, Ethiopia
| | - Tesfaye Kassa
- Department of Laboratory Science and Pathology, Jimma University, Jimma, Po.box -378, Ethiopia
| | - Tsegaye Sewunet
- Department of Laboratory Science and Pathology, Jimma University, Jimma, Po.box -378, Ethiopia
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Environmental contaminants in hospital settings and progress in disinfecting techniques. BIOMED RESEARCH INTERNATIONAL 2013; 2013:429780. [PMID: 24286078 PMCID: PMC3830765 DOI: 10.1155/2013/429780] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 09/17/2013] [Indexed: 01/22/2023]
Abstract
Medical devices, such as stethoscopes, and other objects found in hospital, such as computer keyboards and telephone handsets, may be reservoirs of bacteria for healthcare-associated infections. In this cross-over study involving an Italian teaching hospital we evaluated microbial contamination (total bacterial count (TBC) at 36°C/22°C, Staphylococcus spp., moulds, Enterococcus spp., Pseudomonas spp., E. coli, total coliform bacteria, Acinetobacter spp., and Clostridium difficile) of these devices before and after cleaning and differences in contamination between hospital units and between stethoscopes and keyboards plus handsets. We analysed 37 telephone handsets, 27 computer keyboards, and 35 stethoscopes, comparing their contamination in four hospital units. Wilcoxon signed-rank and Mann-Whitney tests were used. Before cleaning, many samples were positive for Staphylococcus spp. and coliforms. After cleaning, CFUs decreased to zero in most comparisons. The first aid unit had the highest and intensive care the lowest contamination (P < 0.01). Keyboards and handsets had higher TBC at 22°C (P = 0.046) and mould contamination (P = 0.002) than stethoscopes. Healthcare professionals should disinfect stethoscopes and other possible sources of bacterial healthcare-associated infections. The cleaning technique used was effective in reducing bacterial contamination. Units with high patient turnover, such as first aid, should practise stricter hygiene.
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Zaghi J, Zhou J, Graham DA, Potter-Bynoe G, Sandora TJ. Improving stethoscope disinfection at a children's hospital. Infect Control Hosp Epidemiol 2013; 34:1189-93. [PMID: 24113603 DOI: 10.1086/673454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Stethoscopes are contaminated with pathogenic bacteria and pose a risk for transmission of infections, but few clinicians disinfect their stethoscope after every use. We sought to improve stethoscope disinfection rates among pediatric healthcare providers by providing access to disinfection materials and visual reminders to disinfect stethoscopes. DESIGN Prospective intervention study. SETTING Inpatient units and emergency department of a major pediatric hospital. PARTICIPANTS Physicians and nurses with high anticipated stethoscope use. METHODS Baskets filled with alcohol prep pads and a sticker reminding providers to regularly disinfect stethoscopes were installed outside of patient rooms. Healthcare providers' stethoscope disinfection behaviors were directly observed before and after the intervention. Multivariable logistic regression models were created to identify independent predictors of stethoscope disinfection. RESULTS Two hundred twenty-six observations were made in the preintervention period and 261 in the postintervention period (83% were of physicians). Stethoscope disinfection compliance increased significantly from a baseline of 34% to 59% postintervention (P < .001). In adjusted analyses, the postintervention period was associated with improved disinfection among both physicians (odds ratio [OR], 2.3 [95% confidence interval (CI), 1.4-3.5]) and nurses (OR, 14.3 [95% CI, 4.6-44.6]). Additional factors independently associated with disinfection included subspecialty unit (vs general pediatrics; OR, 0.5 [95% CI, 0.3-0.8]) and contact precautions (OR, 2.3 [95% CI, 1.2-4.1]). CONCLUSIONS Providing stethoscope disinfection supplies and visible reminders outside of patient rooms significantly increased stethoscope disinfection rates among physicians and nurses at a children's hospital. This simple intervention could be replicated at other healthcare facilities. Future research should assess the impact on patient infections.
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Pinon A, Gachet J, Alexandre V, Decherf S, Vialette M. Microbiological Contamination of Bed Linen and Staff Uniforms in a Hospital. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/aim.2013.37069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Predictors of stethoscope disinfection among pediatric health care providers. Am J Infect Control 2012; 40:922-5. [PMID: 22475570 DOI: 10.1016/j.ajic.2011.11.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 11/28/2011] [Accepted: 11/28/2011] [Indexed: 12/16/2022]
Abstract
BACKGROUND Stethoscopes are contaminated with bacteria, but predictors of stethoscope disinfection frequency are unknown. We sought to describe health care provider stethoscope disinfection attitudes and practices and determine predictors of frequent disinfection. METHODS We used an anonymous online survey of nurses, nurse practitioners, and physicians at a pediatric hospital. We assessed frequency and methods of disinfection, perceptions of contamination, and barriers to disinfection. Multivariate logistic regression models were used to identify independent predictors of disinfecting after every use. RESULTS One thousand four hundred one respondents completed the survey: 76% believed that infection transmission occurs via stethoscopes, but only 24% reported disinfecting after every use. In multivariate analyses, belief that infection transmission occurs via stethoscopes significantly increased the odds of disinfection after every use (odds ratio [OR], 2.06 [95% confidence interval (CI): 1.38-3.06]). The odds of disinfection after every use were significantly decreased in those who perceived the following barriers: lack of time (OR, 0.31 [95% CI: 0.18-0.54]), lack of access to disinfection material (OR, 0.41 [95% CI: 0.29-0.57]), or lack of visual reminders to disinfect (OR, 0.22 [95% CI: 0.14-0.34]). CONCLUSION Only a minority of pediatric health care providers reported disinfecting their stethoscopes after every use. Increasing access to disinfection materials and visual reminders in health care facilities may improve stethoscope disinfection practices.
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KuKanich KS, Ghosh A, Skarbek JV, Lothamer KM, Zurek L. Surveillance of bacterial contamination in small animal veterinary hospitals with special focus on antimicrobial resistance and virulence traits of enterococci. J Am Vet Med Assoc 2012; 240:437-45. [PMID: 22309016 DOI: 10.2460/javma.240.4.437] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prevalence of bacterial contamination on 4 surfaces of 4 types of standard equipment in small animal veterinary hospitals. DESIGN Surveillance study. SAMPLE 10 small animal veterinary hospitals. PROCEDURES Each hospital was visited 3 times at 4-month intervals; at each visit, a cage door, stethoscope, rectal thermometer, and mouth gag were swabbed. Swab samples were each plated onto media for culture of enterococci and organisms in the family Enterobacteriaceae. Enterococci were identified via a species-specific PCR assay and sodA gene sequencing; species of Enterobacteriaceae were identified with a biochemical test kit. Antimicrobial susceptibility was assessed via the disk diffusion method. Enterococci were screened for virulence traits and genotyped to assess clonality. RESULTS Among the 10 hospitals, enterococci were isolated from cage doors in 7, from stethoscopes in 7, from thermometers in 6, and from mouth gags in 1; contamination with species of Enterobacteriaceae was rare. Enterococci were mainly represented by Enterococcus faecium (35.4%), Enterococcus faecalis (33.2%), and Enterococcus hirae (28.3%). Antimicrobial resistance was common in E. faecium, whereas virulence traits were present in 99% of E. faecalis isolates but not in E. faecium isolates. Clonal multidrug-resistant E. faecium was isolated from several surfaces at 1 hospital over multiple visits, whereas sporadic nonclonal contamination was detected in other hospitals. CONCLUSIONS AND CLINICAL RELEVANCE Contamination of surfaces in small animal veterinary hospitals with multidrug-resistant enterococci is a potential concern for pets and humans contacting these surfaces. Implementing precautions to minimize enterococcal contamination on these surfaces is recommended.
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Affiliation(s)
- Kate S KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
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"Can religious icons be vectors of infectious diseases in hospital settings?". Am J Infect Control 2009; 37:861-3. [PMID: 19541389 DOI: 10.1016/j.ajic.2009.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 03/07/2009] [Accepted: 03/12/2009] [Indexed: 11/23/2022]
Abstract
According to Jewish tradition, Mezuzahs should be affixed on all doorposts leading to communal places. We evaluated the bacterial pathogenic load on the Mezuzah covers in our hospital. Mezuzahs were sampled in all hospital departments, and cultures were carried out. Serving as a control group, door handles belonging to the same departments were tested as well. Most samples harbored potential pathogens. Few cultures were positive in the control group, demonstrating that regular disinfection is carried out, but apparently religious artifacts are overlooked.
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