Stethoscopes Clinicians Gift to Patients Titilayo Oluwabusi MD
Stethoscopes : Clinician’s Gift to Patients Titilayo Oluwabusi MD, Tochi Iroku-Malize MD MPH, Neubert Philippe MD, Oluwafunmilayo Fapohunda MD, Valeria Loukanova MD Hofstra North Shore-LIJ School of Medicine Department of Family Medicine Southside Hospital Family Medicine Residency Program BACKGROUND With the continuous outbreaks of various infections despite the push for hand hygiene, it begs the question if stethoscopes are a contributor to the spread of pathogens from patient to patient. Several studies have already been done to try to establish the role of stethoscopes in possible transmission of disease causing pathogens (1) (2) (3) (4) (5) (6). The aim of this study is to identify common pathogens with aim of making recommendations to help reduce the transmission of these organisms. MATERIALS AND METHODS • Prospective, stratified random sampling method of 40 stethoscope and 4 floors. • This study was carried out by residents of the Hofstra North Shore-LIJ School of Medicine Family Medicine Residency Program at Southside Hospital in NY. • Samples were obtained from participant’s stethoscope and work stations by using the Culture. Swab plus. • These were then sent for identification and sensitivity in the facilities laboratory. • The data was subsequently analyzed using the FREQ procedure. • Variables: • Independent – Nurses, therapist, Residents, attendings • Dependent – interviewers skills, sample collection and analysis methodology RESULTS Health Professional Attending Physician Number of Samples Percent Positive Culture 25 17 (68%) Pathogens CONS (n=17) Alpha Strep (n=1) EF VRE (n = 1) Emergency Room Physician Assistant 1 0 New Stethoscope 1 0 Nurse 7 3 (43%) CONS (n=3) Resident 6 4 (66. 7%) CONS (n=4) Work Top 4 4 (100%) CONS (n=3) The study population consisted of • 25 attending physicians from different specialties (Pulmonologist, cardiologist, nephrologist, hospitalist, traditional family physicians, emergency room physicians), • 15 other healthcare providers (nurses, residents and PAs) and • 4 work stations. MRSA (n=1) Micrococcus (n=1) 28(63%) of all samples were positive. This however was split into positive cultures for 60% providers and 100% work station. Majority of the cultures (27 or 61. 36%) grew coagulase negative Staph aureus. One work station (25%) grew MRSA and one (2. 5%) of the providers’ stethoscope grew Vancomycin resistant E. faecium. Other identified organism include Alpha Streptococcus (n=1) on a provider’s stethoscope, Bacillus sp. (n=1) and Micrococcus sp (n=1) on different work stations. . Bacillus (n=1) Sample size: 44 (consisting of steths and work tops) Alpha level 0. 01 (p value) Anticipated effect size 0. 35 Number of Predictors - 3 Statistical power 0. 8 Study setting NSLIJ SSH Data Collection Oral interviews and documentation CONCLUSIONS This result shows that bacterial contamination of stethoscopes and work station is highly prevalent even on work stations that are routinely cleaned daily. Daily cleaning of stethoscopes and workstations should be advocated to prevent transmission of pathogenic strains to innocent victims. Cleaning these surfaces should be done as frequently as permissible. BIBLIOGRAPHY 1. Survey of Staphylococcus isolates among hospital personnel, environment and their antibiogram with special emphasis on methicillin resistance. Shobha, K L, Rao, P S and Thomas, J. s. l. : Indian J Med Microbiol, 2005, Vols. 23(3); 186 -8. 2. Contaminated physician's stethoscope – a potential source of transmission of infection in the hospital. Need of frequent disinfection after use. Panhotra, B R, Saxena, A K and Al-Mulhim, A S. s. l. : Saudi Med J. , 2005, Saudi J Med, pp. 26(2): 348 -50. 3. The health professionals role in preventing nosocomial infections. Saloojee, H and Steenhoff, A. s. l. : Postgrad Med J. , 2001, Vols. 77 (903): 16 -9. 4. Stethoscope and nosocomial infection. Sengupta, S, Sirkar, A and Shivananda, P G. s. l. : Indian J Pediatr, 2000, Vols. 67(3): 197 -9. 5. Contaminated stethoscopes: a potential source of nosocomial infections. Manji, R J and Andriole, V T. s. l. : Yale J Biol Med, 1972, Vols. 45(6): 600 -4. 6. Stethoscope contamination in the neonatal intensive care unit. Wright, I M, Orr, H and Porter, C. s. l. : J Hosp Infect, 1995, Vols. 29(1): 65 -8.
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