Stethoscope Hygiene Research Articles

Patients and Healthcare Professionals’ Perceptions of Stethoscope Barriers

Stethoscope hygiene is rarely performed despite evidence that they are a potential source of nosocomial infections. Aseptic touch-free disposable stethoscope diaphragm barriers (touch-free barriers) provide a bacteriologically impervious surface; however, little is known about perceptions of touch-free barriers. The purpose of this study was to determine patients’ and healthcare professionals’ perceptions of stethoscope hygiene habits, cleanliness, and patient safety, after respondents viewed videos of stethoscope hygiene with alcohol versus a touch-free barrier, or no hygiene/no barrier. We conducted a cross-sectional study using survey methodology and convenience sampling. Participants viewed three short videos that showed a provider using each of three stethoscope hygiene techniques (barrier, alcohol, or none), followed by completion of a brief survey. Pearson’s chi-square, Fisher’s exact, Wilcoxon rank sum or Kruskal-Wallis tests were used as appropriate. Bonferroni correction was used to control error rate at 0.05 for each question. The sample size of 240 participants included 119 patients and 121 healthcare professionals. Patients rarely witnessed healthcare professionals cleaning stethoscopes, rated clean stethoscopes as important, and were more likely to choose touch-free barrier as easiest for providers. Healthcare professionals rated stethoscope hygiene as important, reported frequent stethoscope hygiene, and felt that touch-free barrier would improve workflow. Touch-free barriers were viewed positively by respondents. Hospitals should consider touch-free barriers as an important strategy to reduce nosocomial infections.

The Cost of Stethoscope Hygiene vs. the Cost of Hygiene Failure

The Cost of Stethoscope Hygiene vs. the Cost of Hygiene Failure

Stethoscope barriers narrative review; It's time for a strategy unfriendly to multi-drug resistant organisms (MDROs)

The current standard of stethoscope hygiene doesn’t eliminate the transmission of harmful pathogens, including multi-drug resistant organisms (MDROs). In the era of the increasing prevalence of MDRO infections, the use of new systems providing touch free barriers may improve patient safety versus traditional stethoscope cleaning practices with chemical agents. Our purpose was to provide a narrative literature review regarding barriers as an improvement over the current standard of care for stethoscope hygiene. Searching PubMed, articles were identified if they were in English and published after 1990, using the search term “stethoscope barrier”, or if they were from a previously published stethoscope hygiene article using “author’s name + stethoscope”. Included articles evaluated or discussed stethoscope barriers. Of 28 manuscripts identified, 15 met the inclusion criteria. Barriers were considered superior to alternatives if they were single use, disposable, applied in a touch free fashion, were impervious to pathogens, provided an aseptic patient contact, and were acoustically invisible. Use of a practitioner’s personal stethoscope with a disposable diaphragm barrier should be recommended as a new standard of care as this represents an improvement in patient safety and patient experience when compared to the disposable stethoscope or isopropyl alcohol stethoscope diaphragm cleaning.

Stethoscope hygiene practices among physicians and medical students at a public hospital in guyana: A Comparative study on knowledge, attitudes and microbial contamination

Stethoscope hygiene practices among physicians and medical students at a public hospital in guyana: A Comparative study on knowledge, attitudes and microbial contamination

Stethoscopes as vectors of staphylococci at a veterinary teaching hospital

The issue of nosocomial infections, or healthcare-associated infections (HAIs), remains a significant concern in healthcare settings worldwide. In recent times, there has been growing attention towards medical devices, notably stethoscopes, as potential vectors for pathogen transmission. This study aimed to evaluate the prevalence of Staphylococcal contamination on stethoscopes used by students and staff at Istanbul University-Cerrahpasa Faculty of Veterinary Medicine’s animal hospital. Furthermore, it gathered information about stethoscope usage habits, cleaning practices, handwashing routines, participants' knowledge about nosocomial infections, and their interest in learning more about these infections and stethoscope hygiene. The analysis of 50 stethoscope samples revealed that 27 (54%) were contaminated with one or more Staphylococci. The isolated 30 Staphylococcus spp. included Staphylococcus epidermidis (n=17; 56.7%), Staphylococcus hominis (n=10; 33.3%), Staphylococcus pasteuri (n=1; 3.3%), Staphylococcus capitis (n=1; 3.3%), and Staphylococcus schleiferi (n=1; 3.3%). Notably, the absence of the highly pathogenic Staphylococcus aureus in all samples provides some reassurance. However, the presence of various Staphylococcus spp. raises concerns due to their pathogenic potential. These findings align with previous research on stethoscope contamination, emphasizing the persistent problem of bacterial colonization on these crucial medical devices. Despite variations in bacterial prevalence among studies, Staphylococcus spp. consistently emerge as common contaminants, emphasizing the need for comprehensive stethoscope hygiene protocols in veterinary healthcare settings. To the best of our knowledge, this is the first report describing the vector potential of stethoscopes in a veterinary setting within Turkey. The study suggests the necessity for further research, taking a proactive approach to tackle the challenges of nosocomial infections. This would enable the development of strategies to ensure a safer healthcare environment for patients and healthcare providers.

Stethoscope Hygiene, Workflow, and Patient Safety: The Crux of Healthcare Associated Infections

Background: Alcohol based hand cleaners are installed throughout almost every health care facility in support of hand hygiene. However, despite numerous attempts, no study has ever demonstrated this strategy is effective for the stethoscope, which carries the same pathogens. Recently, a touch free disposable barrier stethoscope diaphragm system became available (The Disk Cover; Aseptiscope, Inc, San Diego, CA). Our objective was to perform a pilot feasibility trial to evaluate the impressions and perceived workflow consequences of its installation in the clinical environment. Patients and Methods: Beginning in 2020, we performed a volunteer survey given to aseptic stethoscope diaphragm barrier users in multiple US healthcare facilities. A 10-question survey was presented on an iPad near the aseptic barrier dispenser, which was usually located in the patient’s exam room, to be available immediately after the practitioner completed their examination, which included the use of the stethoscope barrier. This evaluation was considered as a quality improvement project and was exempt from IRB approval. For this analysis, only one survey per practitioner was included. Data presented as means (standard deviation). Results: Overall 147 surveys obtained from seven institutions geographically distributed across the US, shortly after placement of the Disk Cover system in the patient care environment. Responses were generally positive, and included ease of use (93.5% rated easy or very easy), comparison to a disposable stethoscope (100% as similar to, improved over, or significant improvement), work-flow changes (63.9% improvement, 97.6% no impact or improved) and perceived effect on patient safety (93.5% felt patient safety was improved or significantly improved). Conclusions: The use of a touch-free aseptic stethoscope barrier system was reported as easy to use, superior to a disposable stethoscope, and was an improvement to practitioner workflow and perceived patient safety

Stethoscopes or Maybe "Bacterioscopes" - Is hand Hygiene Solely Capable of Preventing Hospital-Associated Infections?

The stethoscope remains an indispensable diagnostic tool for medical students. Improper stethoscope hygiene may cause bacterial infections, including hospital-associated infections (HAIs), which challenge the Polish medical system. The study's main objective was to evaluate the hygiene habits declared by medical students. Moreover, microbiological control with the characteristics of potentially pathogenic microorganisms was performed. The study included 66 medical students from the Faculty of Medicine at the Jagiellonian University Medical College in Cracow, Poland. The participants filled in an anonymous questionnaire. Stethoscope contamination was assessed through isolation, identification, testing of antibiotic resistance, and clonality of the isolates bacterial pathogens. The survey showed that only 30.3% of students cleaned their stethoscopes after each patient, and 1.5% never did this. Of the 66 stethoscopes tested, 100% were positive for bacterial growth. Staphylococcus spp. was the most frequently isolated contaminant (50.5%). The questionnaire results demonstrated the necessity of the validated procedures for cleaning the stethoscopes. Stethoscopes used by medical students are contaminated with numerous bacterial species, including multidrug-resistant organisms. The clonal structure of the MRSA and MRSE populations acquired from stethoscopes has been demonstrated. Our results confirm the possibility that these medical devices mediate the spread of hazardous pathogens in the hospital environment. Practical exercises are essential to forming the correct hygiene habits involving stethoscopes, which enable practicing and checking the correctness of the established skills.

Our Third Hand: Stethoscope Hygiene in the Era of Alcohol-Resistant Organisms

The stethoscope is one of the oldest tools in the physician's armamentarium. To this day, it persists as a highly visible image in the practice of medicine, it is used actively and is recommended in most health care encounters, as well as expected by patients.1 Yet, while health care workers have been taught for over 150 years2, and more recently are mandated to perform the WHO five moments of hand hygiene between every single patient,2 stethoscope hygiene practices are only marginally adopted.3, 4 This persists despite the fact that the stethoscope diaphragm carries the same quantity and diversity of healthcare associated pathogens.

A new normal for the clinician's third hand: Stethoscope hygiene and infection prevention

Health care associated infections (HAI) are a substantial problem in contemporary health care. With an estimated annual US cost of 147 billion dollars, HAIs represent avoidable adverse events, the consequence of which are increased health care costs, longer length of stays, with higher rates morbidity and mortality. This is especially true in hematology-oncology practices, as patients are commonly immunocompromised, many are neutropenic, nonintact skin is frequent due to skin graft versus host disease, and broad-spectrum antimicrobial exposure is common, all which increases the risk of iatrogenic complications.

Microbiological Impacts of Decontamination of Stethoscopes and Assessment of Disinfecting Practices among Physicians in Pakistan: A Quality Improvement Survey.

The study was conducted to determine bacterial contamination of stethoscopes used by doctors before and after disinfecting with isopropyl alcohol and analyze their practices of disinfecting stethoscopes. Samples from stethoscopes were taken before and after disinfecting with 70% isopropyl alcohol swab with the help of a sterile swab. All swabs were inoculated on Blood and MacConkey agar plates and were examined for growth. Stethoscopes of 78 doctors were sampled which included 45 (58%) males and 33 (42%) females. Before decontamination of diaphragms with isopropyl alcohol, 27 (34.6%) diaphragms had "growth" while 51 (65.4%) had "no growth." After decontamination with isopropyl alcohol, 5 (6.4%) had "growth" while 73 (93.6%) had "no growth." The most common microorganism isolated from stethoscopes' diaphragms was methicillin-resistant Staphylococcus epidermidis (MRSE), that is, 14 out of 78 (17.9%). The survey also evaluated factors associated with contamination of stethoscopes. Most doctors 71(91%) believe that stethoscopes can be a source of infection and 55.1% (N = 43) responded that both diaphragm and bell of stethoscopes can transmit infections. Many doctors (41%, N = 32) reported that "forgetfulness/laziness" was the barrier which they faced regarding stethoscope hygiene followed by "lack of time" (21.8%, N = 17). The contamination rate (66.6%) is highest in those doctors who are using their stethoscopes for 3-5 years. Of them, 30 doctors (38.5%) never decontaminated their stethoscopes among which 17 had growth in their stethoscopes before cleaning with isopropyl alcohol, while three had growth even after decontamination. Most doctors used sanitizer (29.5%) and isopropyl alcohol (25.6%) as cleaning agents.

Assessing changes in stethoscope hygiene during COVID-19: a multi-centre cross-sectional study

BackgroundThe COVID-19 (SARS-CoV-2) pandemic has increased infection control vigilance across several modes of patient contact. However, it is unknown whether hygiene pertaining to stethoscopes, which carry the potential for pathogenic contamination, has also shifted accordingly.AimTo characterize pandemic-related changes in stethoscope hygiene.MethodsWe surveyed healthcare providers at three major medical centres. Questions quantitatively (Likert scale and frequency) assessed stethoscope hygiene beliefs and practices with two components: before and during COVID-19. Participants were grouped based on performance of optimal stethoscope hygiene (after every patient) before and during COVID-19. Groups were compared using χ2 and analysis of variance (ANOVA).FindingsOf the 515 (10%) who completed the survey, 55 were excluded (N = 460). Optimal hygiene increased from 27.4% to 55.0% (P < 0.001). There were significant increases in Likert scores for all questions pertaining to knowledge of stethoscope contamination (P < 0.001). Belief in stethoscope contamination increased (P < 0.001) despite no change in perceived hygiene education. Resident physicians were less likely compared with attending physicians and nurses to have adopted optimal hygiene during COVID-19 (P < 0.001).ConclusionDespite a positive shift in stethoscope hygiene during COVID-19, optimal hygiene was still only performed by around half of providers. Educational interventions, particularly targeting early-career providers, are encouraged.

Stethoscope hygiene, workflow, and patient safety: The crux of healthcare-associated infections

Objective: We evaluated the impressions and perceived workflow consequences following installation of a touch-free aseptic stethoscope barrier dispenser in the clinical environment. Methods: Beginning in 2020, we conducted a volunteer survey of aseptic stethoscope diaphragm barrier (AseptiScope, San Diego, CA) users in multiple departments at 7 US healthcare facilities. A 10-question survey was presented on an iPad near the aseptic barrier dispenser, which was usually located in the patient exam room, to be available immediately after the practitioner completed their examination, which included the use of the stethoscope barrier. This evaluation was considered a quality improvement project and was exempt from institutional review board approval. For this analysis, only 1 survey per practitioner was included. Results: Overall, 147 surveys were obtained from 7 institutions geographically distributed across the United States, immediately after placement of the DiskCover system in the patient care environment. Responses were generally positive and included ease of use (95.2% rated easy or very easy), comparison to a disposable stethoscope (97.9% as similar to, improved over, or significant improvement), workflow changes (53.7% improvement, 97.3% no impact, or improved), and perceived effect on patient safety (90.3% felt that patient safety was improved or significantly improved). Conclusions: The use of a touch-free aseptic stethoscope barrier system was reported to be easy to use, superior to a disposable stethoscope, and an improvement to practitioner workflow and perceived patient safety.Funding: AseptiScope, Inc.Disclosures: None

An Innovative Experiential Approach to Learning About Quality Improvement Processes.

Baccalaureate nursing students receive education to develop quality and safety competencies. Approaches vary due to time constraints and availability of clinical sites. In this innovative, semester-long activity, student groups applied quality improvement resources from the Institute for Healthcare Improvement, addressing problems such as stethoscope hygiene practices and weekly screen time. Students' evaluation of the experience indicated a growth in knowledge, skills, and positive attitudes toward quality improvement. Experiential nonclinical practices are an innovative and effective way to prepare baccalaureate students for participation in quality improvement activities.

Stethoscope hygiene: A call to action. Recommendations to update the CDC guidelines.

Healthcare-acquired infections are a tremendous challenge to the US medical system. Stethoscopes touch many patients, but current guidance from the Centers for Disease Control and Prevention does not support disinfection between each patient. Stethoscopes are rarely disinfected between patients by healthcare providers. When cultured, even after disinfection, stethoscopes have high rates of pathogen contamination, identical to that of unwashed hands. The consequence of these practices may bode poorly in the coronavirus 2019 disease (COVID-19) pandemic. Alternatively, the CDC recommends the use of disposable stethoscopes. However, these instruments have poor acoustic properties, and misdiagnoses have been documented. They may also serve as pathogen vectors among staff sharing them. Disposable aseptic stethoscope diaphragm barriers can provide increased safety without sacrificing stethoscope function. We recommend that the CDC consider the research regarding stethoscope hygiene and effective solutions to contemporize this guidance and elevate stethoscope hygiene to that of the hands, by requiring stethoscope disinfection or change of disposable barrier between every patient encounter.

An Examination and Comparison of Stethoscope Hygiene in Nursing Education Programs.

Improper stethoscope hygiene has been found to contribute to the development of health care associated infections, which affects approximately one in every 30 hospitalized patients. Various pathogens have been found on the stethoscopes of health care workers. A correlational descriptive design was used to compare stethoscopes from 117 nursing students. Sterile swab samples were obtained from four separate areas of each stethoscope. Samples were plated and incubated for 24 to 48 hours. Bacteria were found on all parts of the stethoscopes from both undergraduate and graduate nursing students, with the earpiece having the highest percentage of contamination. Staphylococcus was the most prevalent microbe found on all four swab sites. Educating students about stethoscope hygiene and consistently reinforcing it in practice are essential to reduce the transmission of pathogens in the health care environment. Nurses can model best practice with students and other disciplines to increase the likelihood of adherence. [J Nurs Educ. 2021;60(5):277-280.].

816. Effectiveness of Aseptic Stethoscope Barriers in Allowing Clean Contact for Clostridioides Difficile-Contaminated Stethoscopes

BackgroundHealthcare-associated infections (HAIs), such as C. difficile colitis, pose a significant health risk. C. difficile is a spore-forming gram-positive anaerobic bacillus capable of surviving on various surfaces. While a strong emphasis has been placed on hand-washing and environmental cleaning with bleach products to limit the spread of C. difficile, stethoscope contamination has been poorly addressed. Studies have demonstrated that the stethoscope diaphragm harbors similar levels and type of contamination to one’s hands. While a non-alcohol-based solution is recommended for stethoscope hygiene in settings at risk for C. difficile, the use of an aseptic stethoscope diaphragm barrier has not been evaluated. Our purpose is to evaluate whether C. difficile-contaminated stethoscope diaphragms remain aseptic by the placement of an aseptic diaphragm barrier.MethodsFresh cultures of C. difficile were diluted to 107 CFU/mL. After inoculating 16 stethoscope diaphragms with C. difficile, 8 had an aseptic diaphragm barrier applied, and 8 served as non-barrier controls. Contaminated stethoscopes were placed in an anaerobic incubator, then swabbed at 15 and 30 minutes, 2 and 4 hours, and 1, 2, 3, and 7 days after inoculation, and subsequently plated onto blood, chocolate, and cycloserine-cefoxitin fructose agar. These plates were incubated for 48 hours, and resulting colonies were manually counted. Statistical analysis was performed (RStudio version 1.0.153) by ANOVA (Analysis of Variance) with post-hoc Tukey HSD (Honestly Significant Difference).ResultsOverall, mean colony count was 33 CFU on the 8 stethoscope diaphragms without barriers, vs zero on those with barriers (p≤ 0.05). Growth rates were greatest at 48 hours, with colony counts as high as 160. While stethoscope diaphragms without barriers had increasing rates of C. difficile culture growth, the presence of the barrier resulted in no growth in 100% of stethoscope diaphragms for up to 1 week after contamination (Figure 1).C. difficile colony counts from stethoscope diaphragms at time-points up to 1 week. ConclusionAseptic barriers allow C. difficile-contaminated stethoscope diaphragms to remain without bacterial growth for up to a week. Disposable aseptic diaphragm barriers may be effective in preventing the spread of C. difficile.DisclosuresWilliam F. Peacock, MD, AseptiScope Inc. (Board Member)

Point of Care Stations: A Novel Way to Improve Stethoscope Hygiene

Background: Stethoscopes are known to be highly contaminated by a multitude of bacteria and therefore carry the potential to transmit pathogens within hospitals. North American infection prevention groups recommend low-level disinfection of stethoscopes for bioburden reduction between patients; however, adherence remains low in inpatient settings. Given that the lack of access to disinfection materials is the most commonly reported barrier to stethoscope hygiene, we studied an intervention using a point-of-care approach to increase stethoscope hygiene compliance among healthcare workers in critical care units. Methods: This quality improvement study was conducted in 2 critical-care units of a quaternary-care, academic, health sciences center in Toronto, Canada. We designed novel stethoscope hygiene stations consisting of a wall-mounted board with alcohol wipes, hooks for drying, and hand sanitizer dispensers to combine stethoscope and hand hygiene. Observations of stethoscope disinfection events per opportunity were collected by trained human auditors before and after the multimodal intervention, which consisted of the installation of 14 stations at the entrances of single-patient ICU rooms, accompanied by educational lectures and infographic dissemination. Anonymous feedback forms were used to gather information on healthcare workers’ stethoscope hygiene knowledge and behavior before and after the intervention. Results: In total, 124 observations were collected using convenience sampling between February and July 2019. Overall stethoscope hygiene compliance increased significantly from a baseline of 38% to 62% (P = .0316) (Fig. 1). Physician adherence to stethoscope disinfection increased by 22%. During the study period, hand hygiene compliance remained unchanged at 75%. Also, 74 healthcare providers completed feedback forms; they revealed an increase in awareness of stethoscope hygiene policies and/or recommendations (9% to 41%) and self reports of stethoscope hygiene compliance (28% to 44%). Conclusions: The implementation of stethoscope hygiene stations, coupled with an educational initiative, lead to a significant increase in overall stethoscope hygiene compliance among healthcare workers. Future quality improvement initiatives can adapt this strategy to promote disinfection and reduce pathogen burden of other personal and multiuse medical equipment.Funding: NoneDisclosures: Susy Hota reports contract research for Finch Therapeutics.

257 Are Stethoscopes and Infection Control Enemies?

The hands and the stethoscope share the same bacteria. While frequent hand washing is the clinical norm, stethoscope hygiene is rarely performed. The placement of disposable barriers on the stethoscope diaphragm has demonstrated to provide an aseptic point of contact, but their effect on auscultation has not been evaluated. Our purpose was to determine if the placement of an aseptic barrier on the stethoscope diaphragm (DiskCover, AseptiScope Inc, San Diego, CA) interferes with its acoustic capability. Using a simulation mannequin and a digital stethoscope (Littmann® 3200, 3M™, Maplewood, MN), we evaluated health care provider’s ability to determine 15 seconds of each of 4 auscultation sounds, with and without an aseptic barrier, the presence of which they were blinded. Digital files of sounds were recorded and analyzed on Logic Pro X to generate objective data of sound amplitude. This difference was analyzed using Wilcoxon Rank Sum test. We also compared the accuracy of auscultation between standard disposable stethoscopes to that of the recording stethoscope with a barrier, which was analyzed using McNemar test. In 800 auscultations, there were no differences in auscultation accuracy by physicians, with (n=400) and without (n=400) a barrier, and no differences in the digital acoustic output tracing (see Table 1). Of 220 auscultations, auscultation mis-diagnosis occurred in 10.9% (n=12/110) of the disposable stethoscope, vs 0% (0/110) with the barrier protected recording stethoscope. Physician’s preferences were uniformly for the aseptic barrier on the recording stethoscope. Aseptic barriers are acoustically invisible and offer a superior, physician preferred, alternative to disposable stethoscopes.Table 1Auscultation accuracy with and without an aseptic barrierAuscultatory soundAccuracy with aseptic barrier N (%)Accuracy without an aseptic barrier N (%)Digital tracing amplitude difference between with and without an aseptic barrier N (%)p-valueNormal heart sounds80(20)80(20)01.00Systolic Murmur100(25)100(25)01.00DiastolicMurmur100(25)100(25)01.00Wheeze120(30)120(30)01.00 Open table in a new tab

Stethoscope hygiene: Using cultures and real-time feedback with bioluminescence-based adenosine triphosphate technology to change behavior

Stethoscope hygiene is rarely done despite guideline recommendations. We wanted to determine whether demonstrating what is growing on the stethoscopes of providers via culture or bioluminescence technology alters perceptions and improves compliance. Providers were given the opportunity to (1) culture their stethoscopes before and after disinfection with alcohol pads, alcohol-based hand rub, or hydrogen peroxide disinfectant wipes and (2) swab stethoscopes for bioluminescence-based adenosine triphosphate testing before and after disinfection. Outcomes were observed for hand and stethoscope hygiene rates and before and after intervention survey responses. The bacteria that were isolated, colony-forming units (CFU), and bioluminescence scores were tracked. A total of 1,245 observed hand hygiene opportunities showed that compliance improved from 72.5%-82.3% (P < .001). In addition, 590 observed patient-provider encounters revealed no significant change in stethoscope hygiene rates of 10% initially and 5% afterward (P = .08), although self-reported rates trended from 56%- 67% postintervention (P = .06). Perceptions regarding stethoscope hygiene importance improved (8.5/10 to 9.3/10; P = .04). Disinfection with alcohol pads, alcohol-based hand rub, and hydrogen peroxide disinfectant wipes were equivalent in CFU reduction (P = .21). Showing providers what is growing on their stethoscopes via cultures and bioluminescence technology before and after disinfection improved "buy in" regarding stethoscope hygiene importance. Both methods were rated as having an equal impact, however, objective observations failed to show improvement.

Stethoscope as potential occupational hazards for intra hospital carries of pathogenic microorganisms

Background: The stethoscope is a tool that doctors use daily in the examination of patients and it can take part in the transmission of health care-associated infections. In a single day it may come in direct contact with multiple patients and the intra hospital environment may be contaminated by various type of bacteria and possibly transmit to others.&#x0D; Objective:- The study was to know the attitude and knowledge about the stethoscope hygiene behavior among physicians and to determine the types of bacterial agents that can contaminate stethoscopes.&#x0D; Type of the study: The study was a cross-sectional study&#x0D; Methods:- It was conducted from 1st of July to end of October 2014 at AL-Emmamain Alkadhomain Medical City in which a convenient sample of 150 physicians were included. A semi constructed questionnaire was used to collect demographic data and hygiene practice among participants. Specimen was collected using moisten sterile cotton swab and then cultured following standard microbiological techniques.&#x0D; The results:- showed a total of 121 (80.6%) of the stethoscopes had bacterial contamination only 29(19.40%) had negative cultures. There is statistically significant association between stethoscope contamination and frequency of cleaning it. Of the studied group only 26 subjects (17.3%) received education regarding stethoscope cleaning.&#x0D; Conclusion:-There was evidence that bacteria can transfer from the skin of the patient to the stethoscope and from the stethoscope to the skin and there was poor education and assessing cleaning practices of stethoscopes.