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Germ-Laden Stethoscopes May Spread Nasty Bacteria

Cleansing after each use should be part of good patient care, study says

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

THURSDAY, Feb. 27, 2014 (HealthDay News) -- Stethoscopes help diagnose and heal, but this primary tool of physicians also has significant potential to spread germs from patient to patient, a new study reports.

The diaphragm of a stethoscope -- the round piece placed against a patient's body -- can become filthy with antibiotic-resistant bacteria such as potentially deadly MRSA, researchers found.

They discovered that a diaphragm will pick up more bacteria during a patient examination than any part of the doctor's hand except the fingertips.

The tube of the stethoscope also can become laden with bacteria, and the contamination level of both the diaphragm and the tube increases with the amount of bacteria on the doctor's fingertips, the study said.

"Germs are acquired from the patient's skin in contact with the stethoscope, the same way hands usually get colonized with the patient's germs," said study senior author Dr. Didier Pittet, director of the Infection Control Program at University of Geneva Hospitals, in Switzerland.

"The important implication is that the stethoscope, whether used by a doctor, a nurse, an assistant nurse or any staff, needs to be cleansed after each use," said Pittet, who also heads the World Health Organization's Collaborating Centre on Patient Safety at the hospitals.

The potential of health care professionals to inadvertently spread disease through their tools or attire is becoming an area of focus because of concerns about the rise of antibiotic-resistant "superbugs."

Epidemiologists -- experts who study disease patterns and causes -- raised the possibility in January that doctors may want to ditch their traditional attire of white coat and necktie, since the articles of clothing can become contaminated and are not easily washed between patients.

The new study compares the level of contamination on physicians' hands and stethoscopes.

In the study, physicians examined 71 patients using sterile gloves and a sterile stethoscope.

After doctors completed the examination, researchers measured the bacteria on the tube and diaphragm of the stethoscope. They also tested the fingertips, ball of the thumb, palm and back of the physicians' hands for bacteria.

They found that the stethoscope and the fingertips tended to be more contaminated than all other parts of the physicians' hands, both with bacteria in general and MRSA (methicillin-resistant Staphylococcus aureus) specifically. They also found that the contamination level of the stethoscope increased with contamination of the hands.

"Although infection cross-transmission from one patient to another has not been demonstrated in this study, it seems clear that staff and doctor stethoscopes constitute an extension of their fingertips in terms of risk for germ's cross-transmission," Pittet said.

"Hand hygiene remains the primary measure for the prevention of hospital infections, and appropriate handling of stethoscopes -- their cleansing immediately after use -- should be part of good patient care practices," Pittet said.

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