9 Bacterial contamination and stethoscope disinfection practices: a cross-sectional survey among residents at king abdulaziz medical city, western region of saudi arabia, 2018

Abstract

Background Although knowledge of healthcare providers regarding stethoscope care is reasonable, their practices regarding stethoscope disinfection after use have been consistently reported to be quite poor, with the results of several hospital- based local and international studies showing a high prevalence of stethoscope contamination. The objective of this study was to assess prevalence of bacterial colonization of stethoscope diaphragms and to explore knowledge, awareness, and practices of residents in different departments. Methods A cross-sectional study was carried out among residents at King Abdulaziz Medical City, the National Guard Hospital, Jeddah, Saudi Arabia, throughout the period 1 April to 31 May 2018. Residents of specialties with expected low stethoscope use were excluded. A 17-item valid self-administered study questionnaire was developed and used for data collection. It included personal characteristics, assessment of residents’ knowledge regarding stethoscope contamination, practice of stethoscope disinfection, and residents’ awareness regarding stethoscope cleaning and disinfection. The stethoscopes used by participants at the time of completing the questionnaire and their diaphragms were sampled for culture and sensitivity. When three or more colony-forming units were found on a plate, the organism was regarded as a bacterial contaminant. The isolated bacteria were assessed by colony characteristics, morphology, and Gram reaction and biochemical tests. Results The study included 170 resident physicians. Their age ranged from 24 to 34 years with a mean of 27.1 (SD 1.7) years. 54.1% were female. The average number of hours of patient contact per 24 hours was 7.0 (SD 2.4) hours. Prevalence of bacterial colonization was 63.5% (108 of 170) whereas that of bacterial contamination was 50.6% (86 of 170). Organisms were present in nine specimens (5.3%). The most common isolated organism was Bacillus sp (three [33.3%] of nine). The highest rate of bacterial contamination was reported among emergency medicine residents (81.8%), whereas the lowest rate was observed among internal medicine residents (32.1%, p=0.001). More experienced residents were more likely to have bacterial contamination, because the mean experience of residents who showed bacterial contamination was significantly higher than others (2.72±1.67 versus 2.27±1.22, p=0.048). Longer time since last cleaning of the stethoscope was significantly associated with bacterial contamination (p=0.020). Conclusion Bacterial contamination of the stethoscope is a common problem among resident physicians, affecting almost half of them, particularly those working in the emergency department and those who had not cleaned their stethoscope for a long time. Therefore, continuing training and education to encourage resident physicians to continuously clean their stethoscope could reduce stethoscope contamination and prevent hospital-acquired infections.