Stethoscopes as vectors of staphylococci at a veterinary teaching hospital

Year 2023, , 132 - 137, 31.12.2023

Eniko Kıraly-avcı , Hüsamettin Avcı , Barış Halaç , Lora Koenhemsi , Prof. Dr. Serkan İkiz

https://doi.org/10.30704/http-www-jivs-net.1365569

Abstract

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.

Keywords

Stethoscope, Staphylococcus, Nosocomial infection, Veterinary, Contamination

References

• Al-Beeshi, N. Z., Alohali, R. M., Torchyan, A. A., & Somily, A. M. (2021). The bacterial colonization of healthcare workers’ mobile phones in a large tertiary care teaching hospital in Saudi Arabia. Journal of Infection in Developing Countries, 15(09), 1314–1320.
• Bagcigil, A. F., Ikiz, S., Guzel, O., Yaramis, C. P., & Ilgaz, A. (2012). Çalışanlarından izole edilen metisiline dirençli stafilokokların tür dağılımları. Journal of The Faculty of Veterinary Medicine Istanbul University , 38(2), 151-160.
• Bataineh, N., Al Momani, W., Abu-Ismail, L., Khamees, A., Malkawi, I., Malkawi, I., Al Momani, L., Saraireh, M., & Khatatbeh, M. (2022). Stethoscope, hand and mobile phone: Bacterial contamination and infection control among medical and nursing students in Jordan. Mediterranean Journal of Infection Microbes and Antimicrobials. 11(8), 1-11.
• Bierowiec, K., Korzeniowska-Kowal, A., Wzorek, A., Rypuła, K., & Gamian, A. (2019). Prevalence of Staphylococcus species colonization in healthy and sick cats. BioMed research international, 2019, 4360525. 1–10.
• Cohn, L. A., & Middleton, J. R. (2010). A veterinary perspective on methicillin-resistant staphylococci. Journal of Veterinary Emergency and Critical Care, 20(1), 31–45.
• Domon, H., Uehara, Y., Oda, M., Seo, H., Kubota, N., & Terao, Y. (2016). Poor survival of methicillin‐resistant Staphylococcus aureus on inanimate objects in the public spaces. MicrobiologyOpen, 5(1), 39–46.
• Duroy, E., & Le Coutour, X. (2010). L’hygiène hospitalière et les étudiants en médecine. Médecine et Maladies Infectieuses, 40(9), 530–536.
• Eriș, F. N., Ürpek, G., & Aktoğu, S. (2000). The investigation of the role of bacterial colonization on the hands and stethescopes of hospital staff in hospital infections. Turkish Journal of Infection, 14(3), 365–367.
• Fujita, H., Hansen, B., & Hanel, R. (2013). Bacterial Contamination of Stethoscope Chest Pieces and the Effect of Daily Cleaning. Journal of Veterinary Internal Medicine, 27(2), 354–358.
• Gazibara, T., Radovanovic, S., Maric, G., Rancic, B., Kisic-Tepavcevic, D., & Pekmezovic, T. (2015). Stethoscope Hygiene: Practice and Attitude of Medical Students. Medical Principles and Practice, 24(6), 509–514.
• Gerken, A., Cavanagh, S., & Winner, H. I. (1972). Infection hazard from stethoscopes in hospital. Lancet, 299(7762), 1214–1215.
• González-Domínguez, M. S., Carvajal, H. D., Calle-Echeverri, D. A., & Chinchilla-Cárdenas, D. (2020). Molecular detection and characterization of the MECA and NUC genes from Staphylococcus species (S. aureus, S. pseudintermedius, and S. schleiferi) isolated from dogs suffering superficial pyoderma and their antimicrobial resistance profiles. Frontiers in Veterinary Science, 7, 376.
• Gupta, N., Gandham, N., Misra, R., Jadhav, S., Ujgare, M., & Vyawahare, C. (2014). The potential role of stethoscopes as a source of nosocomial infection. Medical Journal of Dr. D.Y. Patil University, 7(2), 156.
• Heldeweg, M. L. A., Berend, K., Cadenau, L., Rosingh, A., Duits, A. J., van Mansfeld, R., & Tuinman, P. R. (2022). Bacterial contamination of ultrasound and stethoscope surfaces in low- and high-resource settings. American Journal of Tropical Medicine and Hygiene, 107(2), 463–466.
• Kaspar, U., von Lützau, A., Schlattmann, A., Roesler, U., Köck, R., & Becker, K. (2018). Zoonotic multidrug-resistant microorganisms among small companion animals in Germany. PloseOne, 13(12), e0208364.
• Kilic, I. H., Ozaslan, M., Karagoz, I. D., Zer, Y., Savas, E., & Davutoğlu, V. (2011). The role of stethoscopes in the transmission of hospital infections. African Journal of Biotechnology, 10(30), 5769–5772.
• Lee, A. S., De Lencastre, H., Garau, J., Kluytmans, J., Malhotra-Kumar, S., Peschel, A., & Harbarth, S. (2018). Methicillin-resistant Staphylococcus aureus. Nature Reviews Disease Primers, 4(1), 18033.
• Leite, D. P. S. B. M., Barbosa, I. C., da Silva, R. A., Fernandes, P. R., Abad, A. C. A., da Silva, J. G., Mota, R. A., & Porto, T. S. (2023). Occurrence of antimicrobial-resistant Staphylococcus aureus in a Brazilian veterinary hospital environment. Brazilian journal of microbiology : (publication of the Brazilian Society for Microbiology), 54(3), 2393-2401.
• Leontsini, F., Papapetropoulos, A., & Vantarakis, A. (2013). Stethoscopes as vectors of multi-resistant coagulase negative staphylococci in a tertiary hospital. International Journal of Medical Science and Public Health, 2(2), 324.
• Mangi, R. J., & Andriole, V. T. (1972). Contaminated stethoscopes: A potential source of nosocomial infections. Yale Journal of Biology and Medicine, 45(6), 600-604.
• Marinella, M. A. (1997). The Stethoscope: A potential source of nosocomial infection? Archives of Internal Medicine, 157(7), 786.
• Nivedhitha, E., Duraivel, M., Kayalvili, K. K., & Selvan, S. A. (2021). Study to assess the risk of transmission of microbial organisms and their resistance pattern on dresses and stethoscopes of health care workers. Journal of Pure and Applied Microbiology, 15(3), 1150–1155.
• Núñez, S., Moreno, A., Green, K., & Villar, J. (2000). The stethoscope in the emergency department: A vector of infection? Epidemiology and Infection, 124(2), 233–237.
• Oguzkaya-Artan, M., Baykan, Z., Artan, C., & Avsarogullari, L. (2016). Prevalence and risk factors for methicillin resistant Staphylococcus aureus carriage among emergency department workers and bacterial contamination on touch surfaces in Erciyes University Hospital, Kayseri, Turkey. African Health Sciences, 15(4), 1289.
• Rojas, I., Barquero-Calvo, E., van Balen, J. C., Rojas, N., Muñoz-Vargas, L., & Hoet, A. E. (2017). High prevalence of multidrug-resistant community-acquired methicillin-resistant staphylococcus aureus at the largest veterinary teaching hospital in Costa Rica. Vector-Borne and Zoonotic Diseases, 17(9), 645–653.
• Rossi, C. C., Pereira, M. F., & Giambiagi-deMarval, M. (2020). Underrated staphylococcus species and their role in antimicrobial resistance spreading. Genetics and Molecular Biology, 43(1 suppl 2), e20190065.
• Sivri, N., Bagcigil, A. F., Metiner, K., Seker, D. Z., Orak, S., Durak, S. G., & Sonmez, V. Z. (2016). Culturable airborne bacteria and isolation of methicillin-resistant coagulase-negative staphylococci from outdoor environments on European side of Istanbul, Turkey. Archives of Environmental Protection, 42(3), 77–86.
• Smith, M. A. (1996). Contaminated stethoscopes revisited. Archives of Internal Medicine, 156(1), 82.
• Souza, E. K. M. de, Oliveira, R. P. de, Silva, J. G. da, Mota, R. A., Pinheiro Junior, J. W., Waterloo, M. de M. L., Barretto, M. L. do M., & Oliveira, A. A. da F. (2022). Microbiological evaluation of stethoscopes used in the clinical routine of Veterinarians in the metropolitan region of recife, Pernambuco, Brazil. Research, Society and Development, 8(11), e44611830394.
• Suleyman, G., Alangaden, G., & Bardossy, A. C. (2018). The role of environmental contamination in the transmission of nosocomial pathogens and healthcare-associated infections. Current Infectious Disease Reports, 20(6), 12.