Stethoscopes and otoscopes - a potential vector of infection?
Stethoscopes and otoscopes - a potential vector of infection?
复制标题
DOI：
10.1093/fampra/14.6.446
复制
发表时间：
1997-12-01
期刊：
影响因子：
2.2
通讯作者：
Barzilai, A
中科院分区：
文献类型：
--
作者：
Cohen, HA;Amir, J;Barzilai, A
目标.我们的目的是确定社区儿科诊所使用的听诊器和耳镜是否含有致病微生物，如果是，哪些措施可以防止这种情况。通过两种方法对12个社区诊所儿科医生的55个听诊器进行细菌培养：（i）将每个听诊器的隔膜和钟形部分直接压印在血琼脂平板和甘露醇盐琼脂平板上5秒钟;（ii）用无菌棉头涂抹器擦拭听诊器隔膜的整个表面。通过用棉签擦拭耳镜手柄，对来自相同医生的42个耳镜进行采样。将平板在37 ℃下孵育48小时，并在孵育24和48小时时检查菌落生长。培养结果记录为菌落形成单位（CFU）的平均数。在参与的诊所随机选择另外八个听诊器隔膜，并如上所述进行培养。然后用酒精拭子（70%异丙醇）擦拭，风干约10分钟，并再次培养。所有的听诊器和90%的耳镜手柄都被微生物定殖。从听诊器和耳镜中检出葡萄球菌的比例分别为85.4%和83.3%，其中葡萄球菌占54.5%和45.2%。奥瑞斯耐甲氧西林表皮葡萄在听诊器（7.3%）和耳镜（9.5%）中各发现4个金黄色葡萄球菌。用酒精清洗可使殖民地平均减少96. 3%。污染物可能隐藏潜在的致病细菌，并且随着越来越多的趋势，具有更复杂的医疗问题的儿童在门诊环境中进行管理，通常由也在医院工作的医生进行管理，存在将潜在的严重感染传播给这些患者的真实的风险。简单的酒精清洁可以有效地消除污染物的细菌污染，应该鼓励。
Objectives. We aimed to determine whether stethoscopes and otoscopes used in community paediatric clinics harboured pathogenic micro-organisms, and, if so, which measures could prevent this.Methods. Fifty-five stethoscopes belonging to paediatric physicians working in 12 community clinics were sampled for bacterial cultures by two methods: (i) direct impression of the diaphragm and bell section of each stethoscope for 5 seconds onto blood agar plates and a mannitol-salt-agar plate; (ii) swabbing the entire surface of the diaphragm of the stethoscope with a sterile cotton-tipped applicator. Forty-two otoscopes from the same physicians were sampled by rubbing the handles of the otoscopes with cotton-tipped swabs. The plates were incubated at 37 degrees C for 48 hours and examined for colony growth at 24 and 48 hours of incubation. Culture results were recorded as mean numbers of colony-forming units (CFUs). Eight additional stethoscope diaphragms were chosen at random at the participating clinics and cultured as described above. They were then wiped with alcohol swabs (isopropyl alcohol 70%), allowed to air dry for approximately 10 minutes and cultured a second time.Results. All the stethoscopes and 90% of the otoscope handles were colonized by microorganisms. Staphylococci were isolated from 85.4% of the stethoscopes and 83.3% of the otoscopes, with 54.5% and 45.2% respectively being S. Aureus. Methicillin-resistant S. aureus were found in four each of the stethoscopes (7.3%) and otoscopes (9.5%). Cleaning with alcohol reduced the colony count by an average of 96.3%.Conclusions. Fomites can harbour potentially pathogenic bacteria, and with the increasing trend for children with more complex medical problems to be managed in an ambulatory setting, often by physicians who also work in hospitals, there is a real risk of spreading potentially serious infections to such patients. Simple cleansing with alcohol effectively eliminates the bacterial contamination of the fomites, and should be encouraged.