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Predictors of Heavy Stethoscope Contamination Following a Physical Examination

Published online by Cambridge University Press:  08 March 2016

Clément Tschopp ,
Alexis Schneider ,
Yves Longtin ,
Gesuele Renzi ,
Jacques Schrenzel  and
Didier Pittet
Clément Tschopp
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Alexis Schneider
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Yves Longtin
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Gesuele Renzi
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Jacques Schrenzel
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Didier Pittet*
Affiliation:
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland WORLD HEALTH ORGANIZATION Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
*
Address correspondence to Didier Pittet, MD, MS, Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Gabrielle-Perret-Gentil 4, 1211 Geneve-14, Switzerland (didier.pittet@hcuge.ch).
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Abstract

BACKGROUND

The degree of bacterial contamination of stethoscopes can vary significantly following a physical examination.

OBJECTIVE

To conduct a prospective study to investigate the impact of various environmental and patient characteristics on stethoscope contamination.

METHODS

Following a standardized examination, the levels of bacterial contamination of 4 regions of the physicians’ hands and 2 sections of the stethoscopes, and the presence of different pathogenic bacteria, were assessed. Predictors of heavy stethoscope contamination were identified through multivariate logistic regression.

RESULTS

In total, 392 surfaces were sampled following examination of 56 patients. The microorganisms most frequently recovered from hands and stethoscopes were Enterococcus spp. (29% and 20%, respectively) and Enterobacteriaceae (16% and 7%, respectively). Staphylococcus aureus (either methicillin susceptible or resistant), extended-spectrum β-lactamase–producing Enterobacteriaceae, and Acinetobacter baumannii were recovered from 4%-9% of the samples from either hands or stethoscopes. There was a correlation between the likelihood of recovering these pathogens from the stethoscopes vs from the physicians’ hands (ρ=0.79; P=.04). The level of patient’s skin contamination was an independent predictor of contamination of the stethoscope diaphragm (adjusted odds ratio [aOR], 1.001; P=.007) and tube (aOR, 1.001; P=.003). Male sex (aOR, 28.24; P=.01) and reception of a bed bath (aOR, 7.52; P=.048) were also independently associated with heavy tube contamination.

CONCLUSIONS

Stethoscope contamination following a single physical examination is not negligible and is associated with the level of contamination of the patient’s skin. Prevention of pathogen dissemination is needed.

Infect Control Hosp Epidemiol 2016;37:673–679

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 6 , June 2016 , pp. 673 - 679
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

(Present affiliation: Jewish General Hospital and McGill University Faculty of Medicine, Montreal, Canada [Y.L.])

References

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