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Evaluation of dedicated stethoscopes as a potential source of nosocomial pathogens
Cesar H Guinto1, Edward J Bottone, John T Raffalli
1Division of Infectious Diseases, New York Medical College/Westchester Medical Center, Valhalla, New York 10595, USA.
Objective:
To determine whether the ear tips of dedicated stethoscopes (DS) that are used on patients prescribed contact precautions for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium, or multiple antibiotic-resistant Acinetobacter baumannii become contaminated with these micro-organisms.
Design:
Culture of DS ear tips.
Setting:
A 524-bed tertiary care university hospital.
Methods:
DS ear tips were inoculated directly onto bacteriologic media and incubated for 48 to 72 hours. Growth of more than 10 colonies from the 2 ear tips collectively was indicative of contamination.
Results:
Ear tips of 78 DS from 69 patients were cultured. Ear tips from 17% (13/78) of the DS were contaminated with potentially pathogenic bacteria: 2 with S aureus (1 MRSA), 1 with E faecalis, 7 with Acinetobacter species, 2 with Pseudomonas species, 1 with Escherichia coli, and 1 with Moraxella. None of the stethoscope ear tips was contaminated with the same pathogen for which the patient was prescribed contact precautions (95% CI, 0-3.8%).
Conclusion:
Although the ear tips of DS from patients who were prescribed contact precautions for MRSA, vancomycin-resistant E faecium, or multiple antibiotic-resistant A baumannii were not contaminated with the indicated nosocomial pathogen, 94% of the evaluable ear tips were contaminated, including with MRSA (1.3%) and Acinetobacter (11%). Regular disinfection of ear tips of DS between users should be considered.
Insights
Stethoscope ear tips from patients on contact precautions were not contaminated with targeted pathogens. However, widespread contamination with other bacteria, including MRSA, highlights the need for regular stethoscope disinfection.
Area of Science:
- Infectious Diseases
- Microbiology
- Hospital Epidemiology
Background:
- Healthcare-associated infections (HAIs) pose a significant threat.
- Contact precautions are implemented to prevent the spread of multidrug-resistant organisms (MDROs).
- Stethoscopes are frequently used medical devices that can potentially transmit pathogens.
Purpose of the Study:
- To investigate the contamination of dedicated stethoscope (DS) ear tips with specific MDROs.
- To determine if DS ear tips harbor methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), or multidrug-resistant Acinetobacter baumannii (MDRAB) in patients under contact precautions.
Main Methods:
- A microbiological culture study was conducted on DS ear tips.
- The study involved 78 DS from 69 patients in a tertiary care university hospital.
- Ear tips were cultured, and contamination was defined as >10 colonies.
Main Results:
- None of the DS ear tips were contaminated with the specific MDROs for which patients were on contact precautions.
- However, 17% of DS ear tips showed contamination with potentially pathogenic bacteria.
- Notable contaminants included MRSA (1.3%) and Acinetobacter species (11%).
Conclusions:
- While specific targeted MDROs were not found on DS ear tips, overall contamination was high (94%).
- The presence of other pathogens, including MRSA, underscores a broader contamination risk.
- Regular disinfection of stethoscope ear tips between patient use is recommended to mitigate transmission risks.