Abstract
This study was designed to assess both the potential for bacterial transmission by stethoscopes used by health-care workers in Nigeria and the implications for patient safety and control of hospital-acquired infections. A structured questionnaire was administered to health workers and the surface of the diaphragm of their stethoscopes swabbed for bacteriological analysis using standard techniques. Of the 107 stethoscopes surveyed, 84 (79%) were contaminated with bacteria; 59 (81%) of the contaminated stethoscopes belonged to physicians and 25 (74%) were from other health workers. Isolates included Staphylococcus aureus (54%), Pseudomonas aeruginosa (19%), Enterococcus faecalis (14%), and Escherichia coli (13%). All stethoscopes that had never been cleaned were contaminated while lower levels of contamination were found on those cleaned one week or less before the survey (chi(2) = 22.4, P < .05). Contamination was significantly higher on stethoscopes cleaned with only water (100%) compared to those cleaned with alcohol (49%) (chi(2) = 30.17, P < .05). Significantly fewer (9%) stethoscopes from health workers who washed their hands after seeing each patient were contaminated when compared with the instruments (86%) of those who did not practice hand washing (chi(2) = 23.79, P < .05). E. coli showed the highest antibiotic resistance, while S. aureus showed the highest antibiotic susceptibility. Strict adherence to stethoscope disinfection practices by health workers can minimize cross-contamination and ensure improved patient safety in hospital environments.
Highlights
Infection transmission in the hospital environment remains a significant hazard for hospitalized patients, and health-care workers are potential sources of these infections
Materials and methods The study was conducted from October 2007 to October 2008 in the following health facilities located in Ebonyi State in south-eastern Nigeria: The Federal Medical Centre (FMC), Abakaliki; Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki; Holy Family Hospital, Abakaliki; WestEnd Maternity and Clinic, Abakaliki; Ceno Pharmacy, Abakaliki; Godal Pharmacy, Abakaliki; Grace Hospital, Abakaliki; Presbyterian Joint Hospital, Uburu; Izhia-Mgbo General Hospital, Ezzamgbo; and Primary Health Centre, Isu
Analysis of the study questionnaire revealed that bacterial contamination was related to the time the stethoscope was cleaned prior to the survey (Table 2); results showed that there was 100% bacterial colonization of stethoscopes that had never been cleaned while the least contamination was found on stethoscopes cleaned one week or less before the survey (χ2 = 22.4, df = 3, P < .05)
Summary
Infection transmission in the hospital environment (nosocomial infection) remains a significant hazard for hospitalized patients, and health-care workers are potential sources of these infections. There are increasing reports of the risk of transmitting antibiotic resistant microorganisms from one patient to another on stethoscopes [3,14,15] These antibiotic-resistant organisms are capable of initiating severe infections in a hospital environment and could require contact isolation and aggressive treatment to prevent the spread of the organisms [16]. Examples of such antibiotic-resistant organisms are ceftazidime-resistant Klebsiella pneumonia, vancomycin-resistant enterococci, methicillinresistant staphylococci, ciprofloxin-resistant Pseudomonas aeruginosa, gentamicin-resistant P. This study was designed to assess both the potential for bacterial transmission by stethoscopes used by health-care workers in Nigeria and the implications for patient safety and control of hospital-acquired infections. Strict adherence to stethoscope disinfection practices by health workers can minimize cross-contamination and ensure improved patient safety in hospital environments
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