Objective
To determine differences in the recontamination of stethoscope membranes after cleaning
with chlorhexidine, triclosan, or alcohol.
Methods
Experimental, controlled, blinded trial to determine differences in the bacterial
load on stethoscope membranes. Membranes were cultured by direct imprint after disinfection
with 70% isopropyl alcohol, 1% triclosan, or 1% chlorhexidine and normal use for 4
hours. As a baseline and an immediate effect control, bacterial load of membranes
without disinfection and after 1 minute of disinfection with isopropyl alcohol was
determined as well.
Results
Three hundred seventy cultures of in-use stethoscopes were taken, 74 from each arm.
In the baseline arm the median growth was 10 CFU (interquartile range [IQR], 32-42
CFU); meanwhile, in the isopropyl alcohol immediate-effect arm it was 0 CFU (IQR,
0-0 CFU). In the arms cultured after 4 hours, a median growth of 8 CFU (IQR, 1-28 CFU)
in the isopropyl alcohol arm, 4 CFU (IQR, 0-17 CFU) in the triclosan arm, and 0 CFU
(IQR, 0-1 CFU) in the chlorhexidine arm were seen. No significant differences were
observed between the bacterial load of the chlorhexidine arm (after 4 hours of use)
and that of the isopropyl alcohol arm (after 1 minute without use) (Z = 2.41; P > .05).
Conclusions
Chlorhexidine can inhibit recontamination of stethoscope membranes and its use could
help avoid cross-infection.
Key Words
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References
- The growing importance of non-device-associated healthcare-associated infections: a relative proportion and incidence study at an academic medical center, 2008-2012.Infect Control Hosp Epidemiol. 2014; 35: 200-202https://doi.org/10.1086/674847
- Epidemiology and control of nosocomial infections in adult intensive care units.Am J Med. 1991; 91: S179-84
- How long do nosocomial pathogens persist on inanimate surfaces? A systematic review.BMC Infect Dis. 2006; 6: 130https://doi.org/10.1186/1471-2334-6-130
- Interventions to prevent methicillin-resistant Staphylococcus aureus transmission in health care facilities: what works?.Clin Microbiol Newsl. 2003; 25: 137-144https://doi.org/10.1016/S0196-4399(03)80042-9
- Contaminated stethoscopes revisited.Arch Intern Med. 1996; 156: 82-84
- Stethoscopes and otoscopes—a potential vector of infection?.Fam Pract. 1997; 14: 446-449
- Stethoscopes as potential intrahospital carriers of pathogenic microorganisms.Am J Infect Control. 2014; 42: 82-83https://doi.org/10.1016/j.ajic.2013.06.015
- Prevalence of methicillin-resistant Staphylococcus aureus on the stethoscopes of emergency medical services providers.Prehosp Emerg Care. 2009; 13: 71-74https://doi.org/10.1080/10903120802471972
- Predictive factors for mortality in patients with methicillin-resistant Staphylococcus aureus bloodstream infection: impact on outcome of host, microorganism and therapy.Clin Microbiol Infect. 2013; 19: 1049-1057https://doi.org/10.1111/1469-0691.12108
- Guideline for Disinfection and Sterilization in Healthcare Facilities.(Available from) (Accessed January, 2014)
- Contamination of stethoscopes with MRSA and current disinfection practices.J Hosp Infect. 2009; 71: 376-378https://doi.org/10.1016/j.jhin.2008.11.009
- Stethoscopes as a source of hospital-acquired methicillin-resistant Staphylococcus aureus.J Perianesth Nurs. 2012; 27: 82-87https://doi.org/10.1016/j.jopan.2012.01.004
- The stethoscope. A potential source of nosocomial infection.Arch Intern Med. 1997; 157: 786-790
- Comparison of residual antimicrobial activity of chlorhexidine-containing antiseptics: an express report.J Healthc Infect. 2010; 2: 32-36
- Antiseptics and disinfectants: activity, action, and resistance.Clin Microbiol Rev. 1999; 12: 147-179
- Assessment of the remanent antibacterial effect of a 2% triclosan-detergent preparation on the skin.J Hyg (Lond). 1983; 91: 521-528
- Methods for evaluating topical antibacterial agents on human skin.Antimicrob Agents Chemother. 1974; 5: 323-329
- Stethoscopes and nosocomial infection.Indian J Pediatr. 2000; 67: 197-199
- Bacterial colonization of stethoscopes and the effect of cleaning.J Hosp Infect. 2003; 55: 236-237
- Contamination of stethoscopes and physicians' hands after a physical examination.Mayo Clin Proc. 2014; 89: 291-299https://doi.org/10.1016/j.mayocp.2013.11.016
- Hand hygiene.N Engl J Med. 2011; 364: e24https://doi.org/10.1056/NEJMvcm0903599
- The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals.Am J Epidemiol. 1985; 121: 181-205
- A “solution” for infectious stethoscopes?.Mayo Clin Proc. 2014; 89: 1318https://doi.org/10.1016/j.mayocp.2014.06.010
- Stethoscopes: a possible mode for transmission of nosocomial pathogens.J Clin Diagn Res. 2011; 5: 1173-1176
- Stethoscopes as possible vectors of infection by staphylococci.BMJ. 1992; 305: 1573-1574
- Environmental contamination makes an important contribution to hospital infection.J Hosp Infect. 2007; 65: 50-54
Article info
Publication history
Published online: September 07, 2016
Footnotes
This project was carried out with financial support from Antisepsia Central, S. A. Leon, Guanajuato, Mexico. The company did not participate on the evaluation and discussion of the results.
Conflicts of interest: VA and AM have obtained economic benefits from Antisepsia Central.
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© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
