Bacterial contamination of stethoscopes used by health workers: public health implications
Bacterial contamination of stethoscopes used by health workers: public health implications
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DOI：
10.3855/jidc.701
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发表时间：
2010-07-01
影响因子：
1.9
通讯作者：
Onu, Christian M.
中科院分区：
文献类型：
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作者：
Uneke, Chigozie J.;Ogbonna, Annayo;Onu, Christian M.
背景：本研究旨在评估尼日利亚卫生保健工作者使用听诊器时细菌传播的可能性，以及对患者安全和医院获得性感染控制的影响。方法：对卫生工作者进行结构化问卷调查，并使用标准技术擦拭听诊器隔膜表面进行细菌学分析。结果与结论：调查的107个听诊器中，84个（79%）被细菌污染；59个（81%）受污染听诊器属于医生，25个（74%）来自其他卫生工作者。分离株包括金黄色葡萄球菌（54%）、铜绿假单胞菌（19%）、粪肠球菌（14%）和大肠杆菌（13%）。所有从未清洗过的听诊器均被污染，而在调查前一周或更短时间内清洗过听诊器的听诊器污染程度较低（chi(2) = 22.4, P < 0.05）。纯水清洗听诊器的污染（100%）明显高于酒精清洗听诊器（49%）（chi(2) = 30.17, P < 0.05）。与不洗手的卫生工作者的听诊器（86%）相比，就诊后洗手的卫生工作者的听诊器被污染的比例（9%）显著减少（chi(2) = 23.79, P < 0.05）。大肠杆菌对抗生素的耐药性最高，金黄色葡萄球菌对抗生素的敏感性最高。卫生工作者严格遵守听诊器消毒做法可以最大限度地减少交叉污染，并确保改善医院环境中的患者安全。
Background: 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.Methodology: A structured questionnaire was administered to health workers and the surface of the diaphragm of their stethoscopes swabbed for bacteriological analysis using standard techniques.Results and Conclusions: 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.