Smith M A, Mathewson J J, Ulert I A, Scerpella E G, Ericsson C D
Center for Infectious Diseases, University of Texas at Houston, USA.
Arch Intern Med. 1996 Jan 8;156(1):82-4.
Because of their universal use by medical professionals, stethoscopes can be a source of nosocomial infections.
To determine the frequency of contamination of stethoscopes with bacteria and fungi.
Cultures were obtained from 200 stethoscopes from four area hospitals and outpatient clinics in Houston, Tex. The frequency of stethoscope contamination in different groups of hospital personnel and medical settings was determined. We also measured the frequency of antimicrobial resistance of the staphylococcal strains that were isolated.
One hundred fifty-nine (80%) of the 200 stethoscopes surveyed were contaminated with microorganisms. The majority of organisms that were isolated were gram-positive bacteria, primarily Staphylococcus species. Fifty-eight percent of the Staphylococcus species that were isolated, including four (17%) of 24 Staphylococcus aureus isolates, were resistant to methicillin. Physicians' stethoscopes were contaminated more often than those of other medical personnel groups (P = .02). Stethoscopes used only in designated areas were contaminated less frequently than stethoscopes belonging to individual medical personnel (P = .01). Although stethoscopes were contaminated in all areas, stethoscopes from the pediatric medical setting were contaminated less frequently than those from other hospital areas (P = .009).
Stethoscope use may be important in the spread of infectious agents, including antimicrobial-resistant strains, and strategies to reduce the contamination of stethoscopes should be developed. We recommend disinfection of stethoscopes or regular use of disposable stethoscope covers.
由于医疗专业人员普遍使用听诊器,其可能成为医院感染的一个来源。
确定听诊器被细菌和真菌污染的频率。
从得克萨斯州休斯敦市四家地区医院和门诊诊所的200个听诊器上获取培养物。确定不同医院工作人员群体和医疗环境中听诊器污染的频率。我们还测量了分离出的葡萄球菌菌株的抗菌耐药频率。
在接受调查的200个听诊器中,159个(80%)被微生物污染。分离出的大多数微生物是革兰氏阳性菌,主要是葡萄球菌属。分离出的葡萄球菌属中,58%,包括24株金黄色葡萄球菌分离株中的4株(17%),对甲氧西林耐药。医生的听诊器比其他医务人员群体的听诊器污染更频繁(P = 0.02)。仅在指定区域使用的听诊器比属于个体医务人员的听诊器污染频率更低(P = 0.01)。尽管听诊器在所有区域都有污染,但儿科医疗环境中的听诊器比其他医院区域的听诊器污染频率更低(P = 0.009)。
使用听诊器可能在包括抗菌耐药菌株在内的传染源传播中起重要作用,应制定减少听诊器污染的策略。我们建议对听诊器进行消毒或定期使用一次性听诊器套。