Mayo Clinic Proceedings
Volume 89, Issue 3 , Pages 291-299, March 2014
Contamination of Stethoscopes and Physicians' Hands After a Physical Examination
Data Previously Presented: These data were presented in part at the 49th ICAAC/50th IDSA, San Francisco, CA, September 12-15, 2009 (abstract #K-515).
Yves Longtin, MD, Alexis Schneider, MD, Clément Tschopp, MD, Gesuèle Renzi, MS, Angèle Gayet-Ageron, MD, PhD, Jacques Schrenzel, MD, Didier Pittet, MD, MSemail address
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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 cm2 vs 4 CFUs/25 cm2; 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, ?=0.80; P<.001 and ?=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 (?=0.56; P<.001 and ?=.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.
Abbreviations and Acronyms: ACC, aerobic colony count, CFU, colony-forming unit, HUG, University of Geneva Hospitals, IQR, interquartile range, MRSA, methicillin-resistant Staphylococcus aureus
For editorial comment, see page 277
Dr Longtin is now with the McGill University Faculty of Medicine and Jewish General Hospital, Montreal, Quebec, Canada.
Grant Support: This study was supported by an institutional grant from the University of Geneva Hospitals. The authors also acknowledge the recent funding for partial financial support for hand hygiene research activities by subsidy 3200BO-122324/1 from the Swiss National Science Foundation.
PII: S0025-6196(13)01084-7
doi:10.1016/j.mayocp.2013.11.016
© 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.