1
|
Ehondor OT, Ibadin EE. A Microbiological Assessment of Stethoscopes Used by Clinicians in a Tertiary Hospital in Benin City, Nigeria. Malays J Med Sci 2023; 30:94-101. [PMID: 37655151 PMCID: PMC10467599 DOI: 10.21315/mjms2023.30.4.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/12/2022] [Indexed: 09/02/2023] Open
Abstract
Background The hospital environment serves as a niche for pathogenic microorganisms, so efforts are constantly being made to identify the potential mode of microbial pathogen transmission causing clinical infections. Objective The aim of this study was to microbiologically examine the stethoscopes used by clinicians at the University of Benin Teaching Hospital (UBTH) in Benin, Nigeria. Methods A total of 106 clinicians' stethoscopes were cleaned using cotton-tipped swabs dampened with normal saline. This included both earpieces along with the diaphragm (three samples per stethoscope). The samples were then sent to the Medical Microbiology Laboratory of UBTH and processed immediately as per the standard guidelines. The emergent colonies were subsequently identified, and antimicrobial susceptibility tests were performed. Results A total of 114 (35.8%) bacterial isolates were recovered, including Staphylococcus aureus (S. aureus) (33.3%), coagulase-negative staphylococci (CoNS) (33.3%), Bacillus spp. (22.8%), Acinetobacter spp. (5.3%), Escherichia coli (E. coli) (1.8%) and Klebsiella spp. (3.5%). Diaphragms had the highest yield of methicillin-resistant S. aureus (MRSA) (46.2%) and CoNS (17.9%). Age (P = 0.0387) and cadre of clinician (P = 0.0043) were risk factors for contamination, whereas clinicians who never cleaned their stethoscopes (P = 0.0044) or cleaned only the earpieces (P = 0.0001) had more contaminated stethoscopes. Conclusion The contamination rate of stethoscopes used by clinicians in Benin City was 56.6%. There is a need to establish proper stethoscope cleaning practices for all cadres of personnel in clinical practice to minimise health risks to patients and healthcare workers (HCW).
Collapse
Affiliation(s)
- Ogie Tada Ehondor
- Department of Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Ephraim Ehidiamen Ibadin
- Medical Microbiology Division, Medical Laboratory Services, University of Benin Teaching Hospital, Benin City, Nigeria
| |
Collapse
|
2
|
Adhikari S, Adhikaree N, Paudel KP, Nepal R, Poudel B, Giri S, Khadka S, Khawas S, Sapkota S, Regmi RS, Rijal KR. Bacterial Assessment of Stethoscopes Used by Healthcare Workers at a Tertiary Care Government Hospital in Bharatpur, Nepal. Diseases 2023; 11:diseases11020055. [PMID: 37092437 PMCID: PMC10123714 DOI: 10.3390/diseases11020055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/13/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
The transmission of healthcare-associated infections (HCAIs) in healthcare settings is a serious challenge in the medical fraternity. Medical devices, such as stethoscopes used by healthcare workers (HCWs), are likely to harbor a considerable number of pathogenic microbes, which may result in the transmission of HCAIs. This study sought to investigate bacterial contamination of stethoscopes used by HCWs at Bharatpur Hospital, Nepal. During the study period of 3 months from December 2019 to February 2020, a total of 87 stethoscopes were examined; bacterial pathogens were isolated and identified by culture and biochemical tests, and their susceptibilities against different antibiotics were determined using standard protocols of the Clinical and Laboratory Standards Institute (CLSI). The disc diffusion method was used primarily to screen for extended-spectrum beta-lactamase (ESBL)- and metallo-beta-lactamase (MBL)-producing isolates, followed by their confirmation using cephalosporin/clavulanate combination discs and the disc potentiation methods, respectively. In addition, molecular detection of blaCTX-M and blaVIM genes was performed using conventional polymerase chain reaction (PCR). Of the 87 stethoscopes examined, more than a quarter (28.7%) were colonized with different pathogenic bacteria. Bacterial contamination of stethoscopes was found to be significantly associated with various factors, such as disinfecting routine, method of disinfection, and department of the hospital (p < 0.05). A higher rate of bacterial contamination was observed on the diaphragm of the stethoscope (12.64%) and among HCWs who overlooked hand hygiene practices (45.45%). The prevalence of methicillin-resistant S. aureus (MRSA) was 44.44%, and approximately half of the Gram-negative isolates (47%) were multidrug resistant (MDR). Imipenem (81.25%) and chloramphenicol (83.33%) were found to be the most effective antibiotics for Gram-negative and Gram-positive bacteria, respectively. Phenotypic screening showed that 43.75% of isolates were ESBL producers, and 18.75% were MBL producers, but blaCTX-M and blaVIM genes were detected in only 31.25% and 6.25% of isolates, respectively. The results of the study call for effective stethoscope disinfection practices along with the judicious use of antibiotics by HCWs in order to minimize cross-contamination, emergence of resistance, and spread of nosocomial infections in clinical settings.
Collapse
Affiliation(s)
- Sanjib Adhikari
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44618, Nepal
- Department of Microbiology, Birendra Multiple Campus, Bharatpur 44207, Nepal
| | - Neetu Adhikaree
- Department of Microbiology, Bharatpur Hospital, Bharatpur 44200, Nepal
- Department of Microbiology, College of Medical Sciences, Bharatpur 44207, Nepal
| | | | - Roshan Nepal
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44618, Nepal
- Department of Microbiology, Birendra Multiple Campus, Bharatpur 44207, Nepal
| | - Birendra Poudel
- Department of Microbiology, Birendra Multiple Campus, Bharatpur 44207, Nepal
| | - Sujan Giri
- Department of Microbiology, Birendra Multiple Campus, Bharatpur 44207, Nepal
| | - Suman Khadka
- Department of Microbiology, Birendra Multiple Campus, Bharatpur 44207, Nepal
| | - Saphala Khawas
- Department of Microbiology, Birendra Multiple Campus, Bharatpur 44207, Nepal
| | - Sanjeep Sapkota
- Department of Microbiology, Birendra Multiple Campus, Bharatpur 44207, Nepal
| | - Ramesh Sharma Regmi
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44618, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44618, Nepal
| |
Collapse
|
3
|
Talaga-Ćwiertnia K, Ochońska D, Gajda M, Kowalczyk M, Palczewska M, Brzychczy-Włoch M. Stethoscopes or Maybe "Bacterioscopes" - Is hand Hygiene Solely Capable of Preventing Hospital-Associated Infections? Pol J Microbiol 2023; 72:79-91. [PMID: 36929886 DOI: 10.33073/pjm-2023-012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/13/2023] [Indexed: 03/18/2023] Open
Abstract
The stethoscope remains an indispensable diagnostic tool for medical students. Improper stethoscope hygiene may cause bacterial infections, including hospital-associated infections (HAIs), which challenge the Polish medical system. The study's main objective was to evaluate the hygiene habits declared by medical students. Moreover, microbiological control with the characteristics of potentially pathogenic microorganisms was performed. The study included 66 medical students from the Faculty of Medicine at the Jagiellonian University Medical College in Cracow, Poland. The participants filled in an anonymous questionnaire. Stethoscope contamination was assessed through isolation, identification, testing of antibiotic resistance, and clonality of the isolates bacterial pathogens. The survey showed that only 30.3% of students cleaned their stethoscopes after each patient, and 1.5% never did this. Of the 66 stethoscopes tested, 100% were positive for bacterial growth. Staphylococcus spp. was the most frequently isolated contaminant (50.5%). The questionnaire results demonstrated the necessity of the validated procedures for cleaning the stethoscopes. Stethoscopes used by medical students are contaminated with numerous bacterial species, including multidrug-resistant organisms. The clonal structure of the MRSA and MRSE populations acquired from stethoscopes has been demonstrated. Our results confirm the possibility that these medical devices mediate the spread of hazardous pathogens in the hospital environment. Practical exercises are essential to forming the correct hygiene habits involving stethoscopes, which enable practicing and checking the correctness of the established skills.
Collapse
Affiliation(s)
- Katarzyna Talaga-Ćwiertnia
- 1Department of Molecular Medical Microbiology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Dorota Ochońska
- 1Department of Molecular Medical Microbiology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Mateusz Gajda
- 2Students' Scientific Group of Microbiology at the Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
- 3Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
- 4Doctoral School of Medical Sciences and Health Sciences, Jagiellonian University Medical College, Cracow, Poland
- 5Angiology Department, University Hospital in Cracow, Jagiellonian University Medical College, Cracow, Poland
| | - Monika Kowalczyk
- 2Students' Scientific Group of Microbiology at the Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
- 6Department of Neurology with a Stroke Unit, Żeromski Specialist Hospital, Cracow, Poland
| | - Magdalena Palczewska
- 2Students' Scientific Group of Microbiology at the Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
- 7Metabolic Diseases and Diabetology Clinical Department, University Hospital of Cracow, Cracow, Poland
| | - Monika Brzychczy-Włoch
- 1Department of Molecular Medical Microbiology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| |
Collapse
|
4
|
Tahir MJ, Zaman M, Babar MS, Imran F, Ajmal AN, Malik M, Khan JK, Ullah I, Asghar MS. Microbiological Impacts of Decontamination of Stethoscopes and Assessment of Disinfecting Practices among Physicians in Pakistan: A Quality Improvement Survey. Am J Trop Med Hyg 2022; 107:tpmd211283. [PMID: 35576950 PMCID: PMC9294694 DOI: 10.4269/ajtmh.21-1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 03/26/2022] [Indexed: 11/07/2022] Open
Abstract
The study was conducted to determine bacterial contamination of stethoscopes used by doctors before and after disinfecting with isopropyl alcohol and analyze their practices of disinfecting stethoscopes. Samples from stethoscopes were taken before and after disinfecting with 70% isopropyl alcohol swab with the help of a sterile swab. All swabs were inoculated on Blood and MacConkey agar plates and were examined for growth. Stethoscopes of 78 doctors were sampled which included 45 (58%) males and 33 (42%) females. Before decontamination of diaphragms with isopropyl alcohol, 27 (34.6%) diaphragms had "growth" while 51 (65.4%) had "no growth." After decontamination with isopropyl alcohol, 5 (6.4%) had "growth" while 73 (93.6%) had "no growth." The most common microorganism isolated from stethoscopes' diaphragms was methicillin-resistant Staphylococcus epidermidis (MRSE), that is, 14 out of 78 (17.9%). The survey also evaluated factors associated with contamination of stethoscopes. Most doctors 71(91%) believe that stethoscopes can be a source of infection and 55.1% (N = 43) responded that both diaphragm and bell of stethoscopes can transmit infections. Many doctors (41%, N = 32) reported that "forgetfulness/laziness" was the barrier which they faced regarding stethoscope hygiene followed by "lack of time" (21.8%, N = 17). The contamination rate (66.6%) is highest in those doctors who are using their stethoscopes for 3-5 years. Of them, 30 doctors (38.5%) never decontaminated their stethoscopes among which 17 had growth in their stethoscopes before cleaning with isopropyl alcohol, while three had growth even after decontamination. Most doctors used sanitizer (29.5%) and isopropyl alcohol (25.6%) as cleaning agents.
Collapse
Affiliation(s)
- Muhammad Junaid Tahir
- Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan
- Lahore General Hospital, Lahore, Pakistan
| | - Musharaf Zaman
- Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan
- Lahore General Hospital, Lahore, Pakistan
| | - Muhammad Saad Babar
- Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan
- Lahore General Hospital, Lahore, Pakistan
| | - Fareeha Imran
- Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan
- Lahore General Hospital, Lahore, Pakistan
- Postgraduate Medical Institute, Lahore, Pakistan
| | - Aasma Noveen Ajmal
- Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan
- Lahore General Hospital, Lahore, Pakistan
- Postgraduate Medical Institute, Lahore, Pakistan
| | - Muna Malik
- Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan
- Lahore General Hospital, Lahore, Pakistan
- Postgraduate Medical Institute, Lahore, Pakistan
- Medical Microbiology and Infectious Diseases Society of Pakistan, Karachi, Pakistan
| | - Jalees Khalid Khan
- Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan
- Lahore General Hospital, Lahore, Pakistan
- Postgraduate Medical Institute, Lahore, Pakistan
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
- Undergraduate Research Organization, Dhaka, Bangladesh
- Naseer Teaching Hospital, Peshawar, Pakistan
| | | |
Collapse
|
5
|
Ssekitoleko RT, Oshabaheebwa S, Munabi IG, Tusabe MS, Namayega C, Ngabirano BA, Matovu B, Mugaga J, Reichert WM, Joloba ML. The role of medical equipment in the spread of nosocomial infections: a cross-sectional study in four tertiary public health facilities in Uganda. BMC Public Health 2020; 20:1561. [PMID: 33066745 PMCID: PMC7562759 DOI: 10.1186/s12889-020-09662-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 10/08/2020] [Indexed: 11/11/2022] Open
Abstract
Background With many medical equipment in hospitals coming in direct contact with healthcare workers, patients, technicians, cleaners and sometimes care givers, it is important to pay close attention to their capacity in harboring potentially harmful pathogens. The goal of this study was to assess the role that medical equipment may potentially play in hospital acquired infections in four public health facilities in Uganda. Methods A cross-sectional study was conducted from December 2017 to January 2018 in four public health facilities in Uganda. Each piece of equipment from the neonatal department, imaging department or operating theatre were swabbed at three distinct points: a location in contact with the patient, a location in contact with the user, and a remote location unlikely to be contacted by either the patient or the user. The swabs were analyzed for bacterial growth using standard microbiological methods. Seventeen bacterial isolates were randomly selected and tested for susceptibility/resistance to common antibiotics. The data collected analyzed in STATA version 14. Results A total of 192 locations on 65 equipment were swabbed, with 60.4% of these locations testing positive (116/192). Nearly nine of ten equipment (57/65) tested positive for contamination in at least one location, and two out of three equipment (67.7%) tested positive in two or more locations. Of the 116 contaminated locations 52.6% were positive for Bacillus Species, 14.7% were positive for coagulase negative staphylococcus, 12.9% (15/116) were positive for E. coli, while all other bacterial species had a pooled prevalence of 19.8%. Interestingly, 55% of the remote locations were contaminated compared to 66% of the user contacted locations and 60% of the patient contacted locations. Further, 5/17 samples were resistant to at least three of the classes of antibiotics tested including penicillin, glycylcycline, tetracycline, trimethoprim sulfamethoxazole and urinary anti-infectives. Conclusion These results provides strong support for strengthening overall disinfection/sterilization practices around medical equipment use in public health facilities in Uganda. There’s also need for further research to make a direct link to the bacterial isolates identified and cases of infections recorded among patients in similar settings.
Collapse
Affiliation(s)
- Robert T Ssekitoleko
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Solomon Oshabaheebwa
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ian G Munabi
- Department of Anatomy, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Martha S Tusabe
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - C Namayega
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Beryl A Ngabirano
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Brian Matovu
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Julius Mugaga
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Moses L Joloba
- Department of Microbiology, School of Biomedical Sciences, Makerere University college of Health Sciences, Kampala, Uganda
| |
Collapse
|
6
|
Dîrzu DS. Replacing the stethoscope with ultrasound identification of lung sliding to confirm correct endotracheal tube placement for COVID-19 patients-Time for a paradigm shift? Int J Clin Pract 2020; 74:e13571. [PMID: 32506840 DOI: 10.1111/ijcp.13571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Dan S Dîrzu
- Anesthesia and Intensive Care Department, Emergency County Hospital Cluj-Napoca, Cluj-Napoca, Romania
| |
Collapse
|
7
|
Comparison of Effectiveness of 70%-isopropanol, 65%-ethanol and 1%-chlorhexidine for Stethoscope Decontamination. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.3.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Stethoscopes are potential vector for health care associated infections worldwide. Ethyl alcohol (EA), isopropyl alcohol (IPA) and chlorhexidine (CH) are widely used for disinfecting stethoscope, however, comparative analysis of these disinfectants are scarce. Hence this paper aims to compare the reduction in bioburden with respect to stethoscope decontamination. A randomized, double-blind study was undertaken from various categories of health care workers (HCW) working in various departments. Each participant was asked to fill a questionnaire and diaphragms of their stethoscopes were imprinted on blood agar and sabourauds dextrose agar before and after disinfection with either 65%-EA, 70%-IPA or 1%-CH. The culture plates were incubated aerobically and the growth was further identified. 384 HCW participated in the study. 168 participants never cleaned their stethoscope, out of which 147 respondents (91.6%) comprised of students. EA (47%) and IPA (23%) were the two major types of alcohols used as disinfecting agents. 280 samples showed growth among which 51.8% were potent pathogens. Before disinfection, Staphylococcus aureus (27%) was the predominant pathogen, followed by Klebsiella (6.8%), Enterococcus and Candida respectively. Among the disinfectants used, maximum antimicrobial activity was exhibited by IPA (92.5%) compared to EA (82.5%) and CH (77.8%). Huge lacunae regarding knowledge, attitude and practice of stethoscope maintenance was found among student community. The microbial growth varies at various department. Disinfecting stethoscope with 70%-IPA for just 30 seconds is equally efficient compared to 1 minute and IPA was superior to EA and CH for decontaminating stethoscope. Stethoscopes are potential vector for health care associated infections worldwide. Ethyl alcohol (EA), isopropyl alcohol (IPA) and chlorhexidine (CH) are widely used for disinfecting stethoscope, however, comparative analysis of these disinfectants are scarce. Hence this paper aims to compare the reduction in bioburden with respect to stethoscope decontamination. A randomized, double-blind study was undertaken from various categories of health care workers (HCW) working in various departments. Each participant was asked to fill a questionnaire and diaphragms of their stethoscopes were imprinted on blood agar and sabourauds dextrose agar before and after disinfection with either 65%-EA, 70%-IPA or 1%-CH. The culture plates were incubated aerobically and the growth was further identified. 384 HCW participated in the study. 168 participants never cleaned their stethoscope, out of which 147 respondents (91.6%) comprised of students. EA (47%) and IPA (23%) were the two major types of alcohols used as disinfecting agents. 280 samples showed growth among which 51.8% were potent pathogens. Before disinfection, Staphylococcus aureus (27%) was the predominant pathogen, followed by Klebsiella (6.8%), Enterococcus and Candida respectively. Among the disinfectants used, maximum antimicrobial activity was exhibited by IPA (92.5%) compared to EA (82.5%) and CH (77.8%). Huge lacunae regarding knowledge, attitude and practice of stethoscope maintenance was found among student community. The microbial growth varies at various department. Disinfecting stethoscope with 70%-IPA for just 30 seconds is equally efficient compared to 1 minute and IPA was superior to EA and CH for decontaminating stethoscope.
Collapse
|
8
|
Olorunfemi O, Oyewole O, Oduyemi R. Nursing students' knowledge and practice of infection control in Burns and Medical-Surgical Units at the University of Benin Teaching Hospital, Nigeria, 2019. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2020. [DOI: 10.4103/jnms.jnms_40_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
9
|
Podder AR, Jyothi GS. Wound Dehiscence and Role of Delayed Primary Closure in Gynaecological Oncology. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2018. [DOI: 10.1007/s40944-018-0195-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|