Turns out your doctor’s stethoscope may not be the cleanest thing in the room. Experts say there are ways for doctors to keep their stethoscopes cleaner. Getty Images Stethoscopes and white coats have become an iconic symbol for healthcare professionals. However, despite stethoscopes being used to listen to the heart, lungs, intestines, and even blood flow, it may not be the cleanest device around. A new study published in Infection Control & Hospital Epidemiology, a publication from the Society for Healthcare Epidemiology of America, found that stethoscopes used in the intensive care unit had a significant level of bacteria. Particularly, there were high levels of several bacteria, including Staphylococcus aureus, that can cause serious infections. The researchers sampled stethoscopes from the medical intensive care unit at the University of Pennsylvania hospital. The stethoscopes included 20 traditional reusable stethoscopes that were carried by physicians, nurses, and respiratory therapists. Researchers also analyzed 20 single-patient use disposable stethoscopes in patient rooms. As a control, they monitored 10 unused single-use disposable stethoscopes. Of the 40 stethoscopes that were used with patients, more than half confirmed the presence of Staphylococcus — and at high rates as well. Staphylococcus represented between 7 percent and 14 percent of all bacteria sequenced on the stethoscopes. Other commonly found bacteria included Pseudomonas and Acinetobacter. “This study underscores the importance of adhering to rigorous infection control procedures, including fully adhering to CDC-recommended decontamination procedures between patients, or using single-patient-use stethoscopes in each patient’s room,” said Dr. Ronald Collman, senior study author and professor of medicine, pulmonary, allergy, and critical care at the University of Pennsylvania Perelman School of Medicine, in a statement. The Centers for Disease Control and Prevention (CDC) provides guidelines and recommends stethoscopes be disinfected with a disinfectant registered with the Environmental Protection Agency (EPA) unless the item is visibly contaminated with blood. In that case a tuberculocidal agent or a hypochlorite solution should be used. Dr. Rachael Lee, an assistant professor at the University of Alabama at Birmingham’s Division of Infectious Diseases is a “believer of carrying alcohol wipes and cleaning the head of the stethoscope, the part that touches patients, in between seeing patients in the hospital.” She also recommends that doctors use a patient-specific stethoscope if they are seeing a patient that is on contact precautions or entry limits, to protect the spread of infections. A recent study has shown stethoscopes sanitation practices are often times forgotten among clinicians and many times, stethoscope hygiene and contamination are insufficiently addressed in policy guidelines and regulations. CDC indicate that 1.7 million people in the United States develop hospital-acquired infections. There are also 99,000 associated deaths because of them each year. This increased number of infections is costly, with an estimated economic burden between $20 billion to $45 billion each year. It’s unclear if stethoscopes are a contributing factor to hospital-acquired infections. This particular study did not investigate the transfer patterns of these infections. “This study adds to other data identifying bacteria on practitioners, including neckties, white coat, and shirt sleeves,” Lee told Healthline. “These results point to repeated use of stethoscopes as cause of contamination with a diverse community of bacteria.” Stethoscopes may not be the only object a clinician carries or wears that causes infections to spread from one patient to another. Other items include white coats, neckties, and mobile electronic devices also carrying bacteria according to one University of Wisconsin study. Lee recommends that “neckties should not be worn given the fact that most ties are not cleaned on a daily basis.” The bottom line Stethoscopes are staples in a clinician’s uniform. However, they may be riddled with bacteria, including Staphylococcus aureus, pseudomonas, and Acinetobacter. More studies need to be completed to show the actual degree which stethoscopes contribute to infection spread. There are multiple recommended ways to reduce infection levels on clothing and items used by clinicians. These include cleaning the stethoscope, avoiding neckties, and being “bare below the elbows” on a clinician’s arms. Source
