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Zenbaba D, Sahiledengle B, Beressa G, Desta F, Teferu Z, Nugusu F, Atlaw D, Shiferaw Z, Gezahegn B, Mamo A, Desalegn T, Negash W, Negash G, Mama M, Nigussie E, Chattu VK. Bacterial contamination of healthcare workers' mobile phones in Africa: a systematic review and meta-analysis. Trop Med Health 2023; 51:55. [PMID: 37798670 PMCID: PMC10552405 DOI: 10.1186/s41182-023-00547-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Mobile phones are potential reservoirs for pathogens and sources of healthcare-associated infections. More microbes can be found on a mobile phone than on a man's lavatory seat, the sole of a shoe, or a door handle. When examining patients, frequent handling of mobile phones can spread bacteria. Nevertheless, evidence of bacterial contamination of mobile phones used by healthcare workers in Africa was inconclusive. Thus, this meta-analysis and systematic review was conducted to estimate the pooled prevalence of bacterial contamination of mobile phones used by healthcare workers and the most frequent bacterial isolates in Africa. METHODS We systematically retrieved relevant studies using PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar from July 1, 2023 to August 08, 2023. We included observational studies that reported the prevalence of bacterial contamination of mobile phones among healthcare workers. The DerSimonian-random Laird's effect model was used to calculate effect estimates for the pooled prevalence of bacterial contamination in mobile phones and a 95% confidence interval (CI). RESULTS Among 4544 retrieved studies, 26 eligible articles with a total sample size of 2,887 study participants were included in the meta-analysis. The pooled prevalence of mobile phone bacterial contamination among healthcare workers was 84.5% (95% CI 81.7, 87.4%; I2 = 97.9%, p value < 0.001). The most dominant type of bacteria isolated in this review was coagulase-negative staphylococci (CONS) which accounted for 44.0% of the pooled contamination rate of mobile phones used by healthcare workers, followed by Staphylococcus aureus (31.3%), and Escherichia coli (10.7%). CONCLUSIONS In this review, the contamination of mobile phones used by HCWs with various bacterial isolates was shown to be considerable. The most prevalent bacteria isolates were coagulase-negative staphylococci, Staphylococcus aurous, and Escherichia coli. The prevalence of bacterial contamination in mobile phones varies by country and sub-region. Hence, healthcare planners and policymakers should establish norms to manage healthcare workers' hand hygiene and disinfection after using mobile phones.
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Affiliation(s)
- Demisu Zenbaba
- Department of Public Health, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia.
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Girma Beressa
- Department of Public Health, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Fikreab Desta
- Department of Public Health, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Zinash Teferu
- Department of Public Health, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Fikadu Nugusu
- Department of Public Health, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Daniel Atlaw
- Anatomy Unit, School of Medicine, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Zerihun Shiferaw
- Anatomy Unit, School of Medicine, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Bereket Gezahegn
- Anatomy Unit, School of Medicine, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Ayele Mamo
- Departments of Pharmacy, School of Medicine, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Tesfaye Desalegn
- Departments of Pharmacy, School of Medicine, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Wogene Negash
- Department of Nursing, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Getahun Negash
- Department of Medical Laboratory, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Mohammedaman Mama
- Department of Medical Laboratory, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Eshetu Nigussie
- Department of Medical Laboratory, School of Health Sciences, Madda Walabu University, P.O. Box 76, Goba, Ethiopia
| | - Vijay Kumar Chattu
- Center for Transdisciplinary Research, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, India
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, 442107, India
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Kim YJ, Hong MY, Kang HM, Yum SK, Youn YA, Lee DG, Kang JH. Using adenosine triphosphate bioluminescence level monitoring to identify bacterial reservoirs during two consecutive Enterococcus faecium and Staphylococcus capitis nosocomial infection outbreaks at a neonatal intensive care unit. Antimicrob Resist Infect Control 2023; 12:68. [PMID: 37443079 PMCID: PMC10339505 DOI: 10.1186/s13756-023-01273-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION This study aimed to assess the role of adenosine triphosphate (ATP) bioluminescence level monitoring for identifying reservoirs of the outbreak pathogen during two consecutive outbreaks caused by Enterococcus faecium and Staphylococcus capitis at a neonatal intensive care unit (NICU). The secondary aim was to evaluate the long-term sustainability of the infection control measures employed one year after the final intervention measures. METHODS Two outbreaks occurred during a 53-day period in two disconnected subunits, A and B, that share the same attending physicians. ATP bioluminescence level monitoring, environmental cultures, and hand cultures from healthcare workers (HCW) in the NICU were performed. Pulsed-field gel electrophoresis (PFGE) typing was carried out to investigate the phylogenetic relatedness of the isolated strains. RESULTS Four cases of E. faecium sepsis (patients A-8, A-7, A-9, B-8) and three cases of S. capitis sepsis (patients A-16, A-2, B-8) were diagnosed in six preterm infants over a span of 53 days. ATP levels remained high on keyboard 1 of the main station (2076 relative light unit [RLU]/100 cm2) and the keyboard of bed A-9 (4886 RLU/100 cm2). By guidance with the ATP results, environmental cultures showed that E. faecium isolated from the patients and from the main station's keyboard 1 were genotypically indistinguishable. Two different S. capitis strains caused sepsis in three patients. A total 77.8% (n = 7/9) of S. capitis cultured from HCW's hands were genotypically indistinguishable to the strains isolated from A-2 and A-16. The remaining 22.2% (n = 2/9) were genotypically indistinguishable to patient B-8. Three interventions to decrease the risk of bacterial transmission were applied, with the final intervention including a switch of all keyboards and mice in NICU-A and B to disinfectable ones. Post-intervention prospective monitoring up to one year showed a decrease in blood culture positivity (P = 0.0019) and catheter-related blood stream infection rate (P = 0.016) before and after intervention. CONCLUSION ATP monitoring is an effective tool in identifying difficult to disinfect areas in NICUs. Non-medical devices may serve as reservoirs of pathogens causing nosocomial outbreaks, and HCWs' hands contribute to bacterial transmission in NICUs.
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Affiliation(s)
- Ye Ji Kim
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
- Infection Control Office, Seoul St. Mary's Hospital, Seoul, Republic of Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min Yeong Hong
- Infection Control Office, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Hyun Mi Kang
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
- Infection Control Office, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Sook Kyung Yum
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Ah Youn
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Gun Lee
- Infection Control Office, Seoul St. Mary's Hospital, Seoul, Republic of Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Gómez-Gonzales W, Alvarado-Garcia A, Suárez-Mamani M, Dámaso-Mata B, Panduro-Correa V, Maguiña JL, Pecho-Silva S, Rabaan AA, Rodriguez-Morales AJ, Arteaga-Livias K. Contamination by Antibiotic-Resistant Bacteria on Cell Phones of Vendors in a Peruvian Market. Medicina (B Aires) 2023; 59:medicina59040669. [PMID: 37109628 PMCID: PMC10141064 DOI: 10.3390/medicina59040669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
Background and Objectives. Multiple studies have evaluated the presence of bacterial contamination on cell phones in clinical settings; however, the presence and transmission of antibiotic-resistant bacteria on cell phones in the community have not been adequately elucidated. Material and Methods. A cross-sectional study was carried out to determine the presence of bacteria resistant to antibiotics on the cell phones of vendors in a Peruvian market and the associated factors. A sample of 127 vendors was obtained through stratified probabilistic sampling using a data collection form validated by experts. Cell phone samples were cultured using a standard technique, and antibiotic sensitivity was determined using the Kirby–Bauer technique. Chi-squared and Mann-Whitney U tests were used to determine factors associated with resistance in cell phone cultures. Results. Among the cell phones, 92.1% showed bacterial growth, predominantly Gram-positive bacteria (coagulase-negative staphylococci and Staphylococcus aureus), and 17% of the cultures showed resistance to at least three antibiotics evaluated. Two strains fell into the category of methicillin-resistant S. aureus, and three strains of E. coli had resistance to carbapenems. Conclusions. A short distance between customers and vendors, lack of a cell phone case, and having a cell phone with touchscreen are factors associated with antibiotic-resistant bacteria on cell phones.
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Affiliation(s)
- Walter Gómez-Gonzales
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica 11001, Peru;
| | - Anthony Alvarado-Garcia
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
| | - Marytté Suárez-Mamani
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
| | - Bernardo Dámaso-Mata
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
| | - Vicky Panduro-Correa
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
- Hospital Regional Hermilio Valdizan, Huánuco 15011, Peru
| | - Jorge L. Maguiña
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima 15067, Peru; (J.L.M.); (A.J.R.-M.)
| | | | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia;
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Alfonso J. Rodriguez-Morales
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima 15067, Peru; (J.L.M.); (A.J.R.-M.)
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira 660003, Colombia
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut P.O. Box 36, Lebanon
| | - Kovy Arteaga-Livias
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica 11001, Peru;
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
- Hospital II EsSalud, Huánuco 10001, Peru
- Correspondence:
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He J, Shen X, Zhang N, Sun C, Shao Y. Smartphones as an Ecological Niche of Microorganisms: Microbial Activities, Assembly, and Opportunistic Pathogens. Microbiol Spectr 2022; 10:e0150822. [PMID: 36040152 PMCID: PMC9603676 DOI: 10.1128/spectrum.01508-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/11/2022] [Indexed: 12/31/2022] Open
Abstract
Smartphone usage and contact frequency are unprecedentedly high in this era, and they affect humans mentally and physically. However, the characteristics of the microorganisms associated with smartphones and smartphone hygiene habits remain unclear. In this study, using various culture-independent techniques, including high-throughput sequencing, real-time quantitative PCR (RT-qPCR), the ATP bioluminescence system, and electron microscopy, we investigated the structure, assembly, quantity, and dynamic metabolic activity of the bacterial community on smartphone surfaces and the user's dominant and nondominant hands. We found that smartphone microbiotas are more similar to the nondominant hand microbiotas than the dominant hand microbiotas and show significantly decreased phylogenetic diversity and stronger deterministic processes than the hand microbiota. Significant interindividual microbiota differences were observed, contributing to an average owner identification accuracy of 70.6% using smartphone microbiota. Furthermore, it is estimated that approximately 1.75 × 106 bacteria (2.24 × 104/cm2) exist on the touchscreen of a single smartphone, and microbial activities remain stable for at least 48 h. Scanning electron microscopy detected large fragments harboring microorganisms, suggesting that smartphone microbiotas live on the secreta or other substances, e.g., human cell debris and food debris. Fortunately, simple smartphone cleaning/hygiene could significantly reduce the bacterial load. Taken together, our results demonstrate that smartphone surfaces not only are a reservoir of microbes but also provide an ecological niche in which microbiotas, particularly opportunistic pathogens, can survive, be active, and even grow. IMPORTANCE Currently, people spend an average of 4.2 h per day on their smartphones. Due to the COVID-19 pandemic, this figure may still be increasing. The high frequency of smartphone usage may allow microbes, particularly pathogens, to attach to-and even survive on-phone surfaces, potentially causing adverse effects on humans. We employed various culture-independent techniques in this study to evaluate the microbiological features and hygiene of smartphones, including community assembly, bacterial load, and activity. Our data showed that deterministic processes drive smartphone microbiota assembly and that approximately 1.75 × 106 bacteria exist on a single smartphone touchscreen, with activities being stable for at least 48 h. Fortunately, simple smartphone cleaning/hygiene could significantly reduce the bacterial load. This work expands our understanding of the microbial ecology of smartphone surfaces and might facilitate the development of electronic device cleaning/hygiene guidelines to support public health.
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Affiliation(s)
- Jintao He
- Max Planck Partner Group, Faculty of Agriculture, Life and Environmental Sciences, Zhejiang University, Hangzhou, China
| | - Xiaoqiang Shen
- Max Planck Partner Group, Faculty of Agriculture, Life and Environmental Sciences, Zhejiang University, Hangzhou, China
| | - Nan Zhang
- Max Planck Partner Group, Faculty of Agriculture, Life and Environmental Sciences, Zhejiang University, Hangzhou, China
| | - Chao Sun
- Analysis Center of Agrobiology and Environmental Sciences, Zhejiang University, Hangzhou, China
| | - Yongqi Shao
- Max Planck Partner Group, Faculty of Agriculture, Life and Environmental Sciences, Zhejiang University, Hangzhou, China
- Key Laboratory for Molecular Animal Nutrition, Ministry of Education, Beijing, China
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Blake KS, Choi J, Dantas G. Approaches for characterizing and tracking hospital-associated multidrug-resistant bacteria. Cell Mol Life Sci 2021; 78:2585-2606. [PMID: 33582841 PMCID: PMC8005480 DOI: 10.1007/s00018-020-03717-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/26/2020] [Accepted: 11/17/2020] [Indexed: 12/24/2022]
Abstract
Hospital-associated infections are a major concern for global public health. Infections with antibiotic-resistant pathogens can cause empiric treatment failure, and for infections with multidrug-resistant bacteria which can overcome antibiotics of "last resort" there exists no alternative treatments. Despite extensive sanitization protocols, the hospital environment is a potent reservoir and vector of antibiotic-resistant organisms. Pathogens can persist on hospital surfaces and plumbing for months to years, acquire new antibiotic resistance genes by horizontal gene transfer, and initiate outbreaks of hospital-associated infections by spreading to patients via healthcare workers and visitors. Advancements in next-generation sequencing of bacterial genomes and metagenomes have expanded our ability to (1) identify species and track distinct strains, (2) comprehensively profile antibiotic resistance genes, and (3) resolve the mobile elements that facilitate intra- and intercellular gene transfer. This information can, in turn, be used to characterize the population dynamics of hospital-associated microbiota, track outbreaks to their environmental reservoirs, and inform future interventions. This review provides a detailed overview of the approaches and bioinformatic tools available to study isolates and metagenomes of hospital-associated bacteria, and their multi-layered networks of transmission.
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Affiliation(s)
- Kevin S Blake
- The Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
| | - JooHee Choi
- The Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Gautam Dantas
- The Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, 63130, USA.
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Afridayani M, Prastiwi YI, Aulawi K, Rahmat I, Nirwati H, Haryani. Relationship between hand hygiene behavior and Staphylococcus aureus colonization on cell phones of nurses in the intensive care unit. Belitung Nurs J 2021; 7:24-30. [PMID: 37469800 PMCID: PMC10353620 DOI: 10.33546/bnj.1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/10/2020] [Accepted: 01/10/2021] [Indexed: 07/21/2023] Open
Abstract
Background Healthcare-Associated Infections (HAIs) are infections that often occur in hospitals with Staphylococcus aureus as the primary cause. Staphylococcus aureus is usually found on nurses' hands and easily transferred by contact. Cell phones can be a convenient medium for transmitting bacteria. Accordingly, hand washing is one of the effective ways to prevent the transmission of Staphylococcus aureus. Objective This study aimed to determine the relationship between hand hygiene behavior and the colonization of Staphylococcus aureus on cell phones of nurses in the intensive care unit of the academic hospital. Methods This was an observational study with a cross-sectional design conducted from December 2019 to January 2020. The observations of hand hygiene behaviors were performed on 37 nurses selected using total sampling. Colonization of bacteria on each nurses' cell phone was calculated by swabbing the cell phones' surface. Colony counting was done using the total plate count method. Spearman Rank test and Mann Whitney test were used for data analysis. Results The nurses' hand hygiene behavior was 46.06%. Staphylococcus aureus colonization was found on 18.2% of the nurses' cell phones. However, there was no significant relationship between the nurses' hand hygiene behavior and the colonization of Staphylococcus aureus on their cell phones. Conclusion The hand hygiene behavior of nurses was still low, and there was evidence of Staphylococcus aureus colonization on their cell phones. As there was no relationship between the nurses' hand hygiene behavior with the colonization of Staphylococcus aureus on the cell phones, further research is needed to determine if there is an increase or decrease in colonization before and after regular observations.
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Affiliation(s)
- Meri Afridayani
- Master Program in Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yohana Ika Prastiwi
- Master Program in Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Khudazi Aulawi
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ibrahim Rahmat
- Department of Mental and Community Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hera Nirwati
- Department of Microbiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Haryani
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Olsen M, Campos M, Lohning A, Jones P, Legget J, Bannach-Brown A, McKirdy S, Alghafri R, Tajouri L. Mobile phones represent a pathway for microbial transmission: A scoping review. Travel Med Infect Dis 2020; 35:101704. [PMID: 32360322 PMCID: PMC7187827 DOI: 10.1016/j.tmaid.2020.101704] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Mobile phones have become an integral part of modern society. As possible breeding grounds for microbial organisms, these constitute a potential global public health risk for microbial transmission. OBJECTIVE Scoping review of literature examining microbial's presence on mobile phones in both health care (HC) and community settings. METHODS A search (PubMed&GoogleScholar) was conducted from January 2005-December 2019 to identify English language studies. Studies were included if samples from mobile phones were tested for bacteria, fungi, and/or viruses; and if the sampling was carried out in any HC setting, and/or within the general community. Any other studies exploring mobile phones that did not identify specific microorganisms were excluded. RESULTS A total of 56 studies were included (from 24 countries). Most studies identified the presence of bacteria (54/56), while 16 studies reported the presence of fungi. One study focused solely on RNA viruses. Staphylococcus aureus, and Coagulase-Negative Staphylococci were the most numerous identified organisms present on mobile phones. These two species and Escherichia coli were present in over a third of studies both in HC and community samples. Methicillin-resistant S. aureus, Acinetobacter sp., and Bacillus sp. were present in over a third of the studies in HC settings. CONCLUSIONS While this scoping review of literature regarding microbial identification on mobile phones in HC and community settings did not directly address the issue of SARS-CoV-2 responsible for COVID-19, this work exposes the possible role of mobile phones as a 'Trojan horse' contributing to the transmission of microbial infections in epidemics and pandemics.
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Affiliation(s)
- Matthew Olsen
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Mariana Campos
- Harry Butler Institute, Murdoch University, Murdoch, WA, 6150, Australia
| | - Anna Lohning
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - Peter Jones
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - John Legget
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | | | - Simon McKirdy
- Harry Butler Institute, Murdoch University, Murdoch, WA, 6150, Australia
| | - Rashed Alghafri
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia; Dubai Police, Dubai, United Arab Emirates; Dubai Police Scientists Council, Dubai Police, Dubai, United Arab Emirates; Dubai Future Council on Community Security, Dubai, United Arab Emirates
| | - Lotti Tajouri
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia; Dubai Police Scientists Council, Dubai Police, Dubai, United Arab Emirates; Dubai Future Council on Community Security, Dubai, United Arab Emirates.
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Simmonds R, Lee D, Hayhurst E. Mobile phones as fomites for potential pathogens in hospitals: microbiome analysis reveals hidden contaminants. J Hosp Infect 2020; 104:207-13. [PMID: 31585142 DOI: 10.1016/j.jhin.2019.09.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/10/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Smartphones used in clinical settings harbour potentially pathogenic bacteria, and this may pose an infection risk. Previous studies have relied on culture-based methods. AIM To characterize the quantity and diversity of microbial contamination of hospital staff smartphones using culture-dependent and culture-independent methods; to determine the prevalence of antibiotic-resistant potential pathogens; to compare microbial communities of hospital staff and control group phones. METHODS Smartphones of 250 hospital staff and 191 control group participants were swabbed. The antibiotic resistance profile of Staphylococcus aureus and Enterococcus isolates was determined. Swabs were pooled into groups according to the hospital area staff worked in, and DNA was extracted. The microbial community of the phone was characterized using an Illumina MiSeq metabarcoding pipeline. FINDINGS Almost all (99.2%) of hospital staff smartphones were contaminated with potential pathogens, and bacterial colony forming units (CFUs) were significantly higher on hospital phones than in the control group. Meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) were only detected on hospital mobile phones. Metabarcoding revealed a far greater abundance of Gram-negative contaminants, and much greater diversity, than culture-based methods. Bacillus spp. were significantly more abundant in the hospital group. CONCLUSION This study reinforces the need to consider infection-control policies to mitigate the potential risks associated with the increased use of smartphones in clinical environments, and highlights the limitations of culture-based methods for environmental swabbing.
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Affiliation(s)
- J Gray
- Departments of Microbiology, Birmingham Women's & Children's NHS Foundation Trust, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - P Orton
- Departments of Facilities, Birmingham Women's & Children's NHS Foundation Trust, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
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Cabral J, Ag R. Blue Light Disinfection in Hospital Infection Control: Advantages, Drawbacks, and Pitfalls. Antibiotics (Basel) 2019; 8:antibiotics8020058. [PMID: 31067733 PMCID: PMC6627448 DOI: 10.3390/antibiotics8020058] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/27/2019] [Accepted: 05/02/2019] [Indexed: 01/09/2023] Open
Abstract
Hospital acquired infections (HAIs) are a serious problem that potentially affects millions of patients whenever in contact with hospital settings. Worsening the panorama is the emergence of antimicrobial resistance by most microorganisms implicated in HAIs. Therefore, the improvement of the actual surveillance methods and the discovery of alternative approaches with novel modes of action is vital to overcome the threats created by the emergence of such resistances. Light therapy modalities represent a viable and effective alternative to the conventional antimicrobial treatment and can be preponderant in the control of HAIs, even against multidrug resistant organisms (MDROs). This review will initially focus on the actual state of HAIs and MDROs and which methods are currently available to fight them, which is followed by the exploration of antimicrobial photodynamic therapy (aPDT) and antimicrobial blue light therapy (aBLT) as alternative approaches to control microorganisms involved in HAIs. The advantages and drawbacks of BLT relatively to aPDT and conventional antimicrobial drugs as well as its potential applications to destroy microorganisms in the healthcare setting will also be discussed.
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Affiliation(s)
- João Cabral
- Division of Microbiology, Department of Pathology, Porto Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
| | - Rodrigues Ag
- Division of Microbiology, Department of Pathology, Porto Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
- CINTESIS-Center for Health Technology and Services Research, 4200-450 Porto, Portugal.
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Dancer SJ, Adams CE, Smith J, Pichon B, Kearns A, Morrison D. Tracking Staphylococcus aureus in the intensive care unit using whole-genome sequencing. J Hosp Infect 2019; 103:13-20. [PMID: 31039382 DOI: 10.1016/j.jhin.2019.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/22/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Staphylococcus aureus remains an important bacterial pathogen worldwide. This study utilized known staphylococcal epidemiology to track S. aureus between different ecological reservoirs in one 10-bed intensive care unit (ICU). METHODS Selected hand-touch surfaces, staff hands and air were screened systematically 10 times during 10 months, with patients screened throughout the study. S. aureus isolates were subjected to spa typing and epidemiological analyses, followed by whole-genome sequencing to provide single nucleotide polymorphism (SNP) data. RESULTS Multiple transmission pathways between patients and reservoirs were investigated. There were 34 transmission events, of which 29 were highly related (<25 SNPs) and five were possibly related (<50 SNPs). Twenty (59%) transmission events occurred between colonized patients and their own body sites (i.e. autogenous spread); four (12%) were associated with cross-transmission between patients; four (12%) occurred between patients and hand-touch sites (bedrails and intravenous pump); four (12%) linked airborne S. aureus with staff hands and bedrail; and two (6%) linked bed tables, bedrail and cardiac monitor. CONCLUSION Colonized patients are responsible for repeated introduction of new S. aureus into the ICU, whereupon a proportion spread to hand-touch sites in (or near) the patient zone. This short-term reservoir for S. aureus imposes a colonization/infection risk for subsequent patients. More than half of ICU-acquired S. aureus infection originated from the patients' own flora, while staff hands and air were rarely implicated in onward transmission. Control of staphylococcal infection in the ICU is best served by patient screening, systematic cleaning of hand-touch surfaces and continued emphasis on hand hygiene.
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Goh Z, Chung P. Incidence of meticillin-resistant Staphylococcus aureus contamination on mobile phones of medical students. J Hosp Infect 2019; 101:482-3. [DOI: 10.1016/j.jhin.2019.01.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/28/2019] [Indexed: 11/17/2022]
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Galazzi A, Panigada M, Broggi E, Grancini A, Adamini I, Binda F, Mauri T, Pesenti A, Laquintana D, Grasselli G. Microbiological colonization of healthcare workers' mobile phones in a tertiary-level Italian intensive care unit. Intensive Crit Care Nurs 2019; 52:17-21. [PMID: 30737099 DOI: 10.1016/j.iccn.2019.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/07/2019] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Careful hand hygiene of healthcare workers is recommended to reduce transmission of pathogenic microorganisms to patients. Mobile phones are commonly used during work shifts and may act as vehicles of pathogens. OBJECTIVE To assess the colonizsation rate of intensive care unit healthcare workers' mobile phones before and after work shifts. METHODS Prospective observational study conducted in an academic, tertiary-level intensive care unit. Healthcare workers (including doctors, nurses and healthcare assistants) had their mobile phones sampled for microbiology before and after work shifts. Samples were taken with a swab in a standardizsed modality. RESULTS Fifty healthcare workers participated in the study (91% of the department staff). One hundred swabs were taken from 50 mobile phones. Forty-three healthcare workers (86%) reported a habitual use of their phones during the work shift. All phones (100%) were positive for bacteria. The most frequently isolated bacteria were Coagulase Negative Staphylococci, Bacillus sp. and Methicillin-resistant Staphylococcus aureus (97%, 56%, 17%, respectively). No patient admitted to the intensive care unit during the study period was positive for bacteria found on healthcare workers' mobile phones. No difference in bacteria types and burden was found between the beginning and the end of work shifts. CONCLUSION Healthcare workers' mobile phones are colonized even before the work shift and irrespective of the patients' microbiological flora.
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Affiliation(s)
- Alessandro Galazzi
- Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Mauro Panigada
- Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Elena Broggi
- Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Anna Grancini
- Chemical-Clinical Analysis and Microbiology Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Ileana Adamini
- Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Filippo Binda
- Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Tommaso Mauri
- Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy.
| | - Antonio Pesenti
- Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy.
| | - Dario Laquintana
- Direction of Healthcare Professions Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Giacomo Grasselli
- Anesthesia, Intensive Care and Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy.
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Missri L, Smiljkovski D, Prigent G, Lesenne A, Obadia T, Joumaa M, Chelha R, Chalumeau-Lemoine L, Obadia E, Galbois A. Bacterial colonization of healthcare workers' mobile phones in the ICU and effectiveness of sanitization. J Occup Environ Hyg 2019; 16:97-100. [PMID: 30433853 DOI: 10.1080/15459624.2018.1546051] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Extra-European studies report high rates of multi-drug resistant bacteria colonization of healthcare workers' mobile phones in intensive care units. We aimed to assess the prevalence of bacterial colonization of healthcare workers' mobile phones in an intensive care unit in France and the effectiveness of a sanitization product. We designed a prospective, monocentric study in a 15-bed intensive care unit within a 300-bed private hospital. Bacterial colonization was assessed on 56 healthcare workers' mobile phones immediately before and 5 min after sanitization of the phones with bactericidal wipes. The mobile phones of 42 administrative staff acted as controls. All mobile phones in both groups were colonized. Healthcare workers' phones had a higher number of different bacterial species per phone (2.45 ± 1.34 vs. 1.81 ± 0.74, p = 0.02). Colonization with pathogens did not differ significantly between healthcare workers' and controls' phones (39.3% vs. 28.6%, p = 0.37). Excluding coagulase negative Staphylococcus, Staphylococcus aureus was the most common pathogen found in both groups (19.6% and 11.9%, p = 0.41). Only one healthcare workers' mobile phone was colonized by methicillin-resistant Staphylococcus aureus, and no other multi-drug resistant bacteria was detected. No covariate was associated with pathogen colonization. After sanitization, 8.9% of mobile phones were sterilized, and colonization with pathogenic bacteria decreased (21.4% vs. 39.3%, p = 0.04) as did the number of CFUs/mL (367 ± 404 vs. 733 ± 356, p < 0.001). Colonization of intensive care unit healthcare workers' and administrative staff's mobile phones was similar. Colonization with pathogens was frequent but colonization with multi-drug resistant bacteria was rare. Disinfecting the phones with bactericidal wipes is not completely effective. Specific sanitization protocols and recommendations regarding the management of healthcare workers' mobile phones in intensive care units should be developed. Additionally, good hand hygiene after touching mobile phones should be kept in mind to prevent cross-infections.
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Affiliation(s)
- Louaï Missri
- a Ramsay-Générale de Santé , Hôpital Privé Claude Galien, Service de Réanimation Polyvalente, Quincy-sous-Sénart , France
| | - Daniel Smiljkovski
- a Ramsay-Générale de Santé , Hôpital Privé Claude Galien, Service de Réanimation Polyvalente, Quincy-sous-Sénart , France
| | - Gwénolé Prigent
- b Cerballiance, Site Wissous , Laboratoire de Bactériologie , France
| | - Aude Lesenne
- b Cerballiance, Site Wissous , Laboratoire de Bactériologie , France
| | - Thomas Obadia
- c Institut Pasteur, Unité Malaria: parasites et Hôtes , Département parasites et insectes vecteurs , Paris , France
- d Institut Pasteur - Hub Bioinformatique et Biostatistique , Paris , France
| | - Mohsen Joumaa
- a Ramsay-Générale de Santé , Hôpital Privé Claude Galien, Service de Réanimation Polyvalente, Quincy-sous-Sénart , France
| | - Riad Chelha
- a Ramsay-Générale de Santé , Hôpital Privé Claude Galien, Service de Réanimation Polyvalente, Quincy-sous-Sénart , France
| | - Ludivine Chalumeau-Lemoine
- a Ramsay-Générale de Santé , Hôpital Privé Claude Galien, Service de Réanimation Polyvalente, Quincy-sous-Sénart , France
| | - Edouard Obadia
- a Ramsay-Générale de Santé , Hôpital Privé Claude Galien, Service de Réanimation Polyvalente, Quincy-sous-Sénart , France
- e Centre Hospitalier Intercommunal André Grégoire , Service de Réanimation Polyvalente , Montreuil , France
| | - Arnaud Galbois
- a Ramsay-Générale de Santé , Hôpital Privé Claude Galien, Service de Réanimation Polyvalente, Quincy-sous-Sénart , France
- f AP-HP, Centre Hospitalo-Universitaire Saint-Antoine , Service de Réanimation Médicale , Paris , France
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Stephens B, Azimi P, Thoemmes MS, Heidarinejad M, Allen JG, Gilbert JA. Microbial Exchange via Fomites and Implications for Human Health. Curr Pollut Rep 2019; 5:198-213. [PMID: 34171005 PMCID: PMC7149182 DOI: 10.1007/s40726-019-00123-6] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PURPOSE OF REVIEW Fomites are inanimate objects that become colonized with microbes and serve as potential intermediaries for transmission to/from humans. This review summarizes recent literature on fomite contamination and microbial survival in the built environment, transmission between fomites and humans, and implications for human health. RECENT FINDINGS Applications of molecular sequencing techniques to analyze microbial samples have increased our understanding of the microbial diversity that exists in the built environment. This growing body of research has established that microbial communities on surfaces include substantial diversity, with considerable dynamics. While many microbial taxa likely die or lay dormant, some organisms survive, including those that are potentially beneficial, benign, or pathogenic. Surface characteristics also influence microbial survival and rates of transfer to and from humans. Recent research has combined experimental data, mechanistic modeling, and epidemiological approaches to shed light on the likely contributors to microbial exchange between fomites and humans and their contributions to adverse (and even potentially beneficial) human health outcomes. SUMMARY In addition to concerns for fomite transmission of potential pathogens, new analytical tools have uncovered other microbial matters that can be transmitted indirectly via fomites, including entire microbial communities and antibiotic-resistant bacteria. Mathematical models and epidemiological approaches can provide insight on human health implications. However, both are subject to limitations associated with study design, and there is a need to better understand appropriate input model parameters. Fomites remain an important mechanism of transmission of many microbes, along with direct contact and short- and long-range aerosols.
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Affiliation(s)
- Brent Stephens
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Alumni Memorial Hall 228E, 3201 South Dearborn Street, Chicago, IL 60616 USA
| | - Parham Azimi
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Megan S. Thoemmes
- Department of Pediatrics, University of California San Diego School of Medicine, San Diego, CA USA
| | - Mohammad Heidarinejad
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Alumni Memorial Hall 228E, 3201 South Dearborn Street, Chicago, IL 60616 USA
| | - Joseph G. Allen
- Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Jack A. Gilbert
- Department of Pediatrics, University of California San Diego School of Medicine, San Diego, CA USA
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Kosif R, Avcioglu F. An Examination of Bacterial Contamination of Models Used in Anatomy Laboratories. Interdiscip Perspect Infect Dis 2018; 2018:9201312. [PMID: 30662459 DOI: 10.1155/2018/9201312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/14/2018] [Indexed: 11/17/2022] Open
Abstract
Background Bacterial, viral, and parasitic transmission is a common issue involving items that are used in crowded places and are touched. In this study, it was aimed to identify the types of bacteria on models used in anatomy laboratories and the types of bacteria that contaminate students' hands. Methods Swab samples were taken from 30 models used in the laboratory and from the dominant hands of 94 students prior to and after contact with the models and were examined in the microbiology laboratory. Results Five types of bacteria were isolated from the anatomy models: coagulase-negative staphylococcus, staphylococcus aureus, bacillus spp., enterococcus spp., and escherichia coli. Coagulase-negative staphylococcus, staphylococcus aureus, and bacillus spp. were isolated from the hands of the students before the contact, and additionally, enterococcus spp. were isolated after the contact. The hands were not found to be contaminated with escherichia coli originating from the models, whereas enterococcus spp. were found to be transmitted to the hands after the contact. Conclusion The necessity of washing hands before and after working on the models and the necessity of occasionally disinfecting the models have emerged.
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