Adhikari Sanjib, Adhikaree Neetu, Paudel Krishna Prasad, Nepal Roshan, Poudel Birendra, Giri Sujan, Khadka Suman, Khawas Saphala, Sapkota Sanjeep, Regmi Ramesh Sharma, Rijal Komal Raj
Central Department of Microbiology, Tribhuvan University, Kirtipur 44618, Nepal.
Department of Microbiology, Birendra Multiple Campus, Bharatpur 44207, Nepal.
Diseases. 2023 Apr 1;11(2):55. doi: 10.3390/diseases11020055.
The transmission of healthcare-associated infections (HCAIs) in healthcare settings is a serious challenge in the medical fraternity. Medical devices, such as stethoscopes used by healthcare workers (HCWs), are likely to harbor a considerable number of pathogenic microbes, which may result in the transmission of HCAIs. This study sought to investigate bacterial contamination of stethoscopes used by HCWs at Bharatpur Hospital, Nepal. During the study period of 3 months from December 2019 to February 2020, a total of 87 stethoscopes were examined; bacterial pathogens were isolated and identified by culture and biochemical tests, and their susceptibilities against different antibiotics were determined using standard protocols of the Clinical and Laboratory Standards Institute (CLSI). The disc diffusion method was used primarily to screen for extended-spectrum beta-lactamase (ESBL)- and metallo-beta-lactamase (MBL)-producing isolates, followed by their confirmation using cephalosporin/clavulanate combination discs and the disc potentiation methods, respectively. In addition, molecular detection of and genes was performed using conventional polymerase chain reaction (PCR). Of the 87 stethoscopes examined, more than a quarter (28.7%) were colonized with different pathogenic bacteria. Bacterial contamination of stethoscopes was found to be significantly associated with various factors, such as disinfecting routine, method of disinfection, and department of the hospital ( < 0.05). A higher rate of bacterial contamination was observed on the diaphragm of the stethoscope (12.64%) and among HCWs who overlooked hand hygiene practices (45.45%). The prevalence of methicillin-resistant (MRSA) was 44.44%, and approximately half of the Gram-negative isolates (47%) were multidrug resistant (MDR). Imipenem (81.25%) and chloramphenicol (83.33%) were found to be the most effective antibiotics for Gram-negative and Gram-positive bacteria, respectively. Phenotypic screening showed that 43.75% of isolates were ESBL producers, and 18.75% were MBL producers, but and genes were detected in only 31.25% and 6.25% of isolates, respectively. The results of the study call for effective stethoscope disinfection practices along with the judicious use of antibiotics by HCWs in order to minimize cross-contamination, emergence of resistance, and spread of nosocomial infections in clinical settings.
医疗环境中医疗保健相关感染（HCAIs）的传播是医学界面临的一项严峻挑战。医疗设备，如医护人员（HCWs）使用的听诊器，很可能携带大量致病微生物，这可能导致HCAIs的传播。本研究旨在调查尼泊尔巴拉特普尔医院医护人员使用的听诊器的细菌污染情况。在2019年12月至2020年2月为期3个月的研究期间，共检查了87个听诊器；通过培养和生化试验分离并鉴定细菌病原体，并使用临床和实验室标准协会（CLSI）的标准方案确定它们对不同抗生素的敏感性。纸片扩散法主要用于筛选产超广谱β-内酰胺酶（ESBL）和金属β-内酰胺酶（MBL）的菌株，随后分别使用头孢菌素/克拉维酸组合纸片和纸片增效法进行确认。此外，使用常规聚合酶链反应（PCR）对 和 基因进行分子检测。在检查的87个听诊器中，超过四分之一（28.7%）被不同的病原菌定植。发现听诊器的细菌污染与多种因素显著相关，如消毒常规、消毒方法和医院科室（<0.05）。在听诊器的膜片上观察到较高的细菌污染率（12.64%），在忽视手卫生习惯的医护人员中细菌污染率也较高（45.45%）。耐甲氧西林 （MRSA）的患病率为44.44%，大约一半的革兰氏阴性分离株（47%）对多种药物耐药（MDR）。亚胺培南（81.25%）和氯霉素（83.33%）分别被发现是对革兰氏阴性菌和革兰氏阳性菌最有效的抗生素。表型筛选显示，43.75%的分离株产ESBL，18.75%的分离株产MBL，但分别仅在31.25%和6.25%的分离株中检测到 和 基因。研究结果呼吁采取有效的听诊器消毒措施，同时医护人员合理使用抗生素，以尽量减少临床环境中的交叉污染、耐药性的出现和医院感染的传播。
