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Microbiological Impacts of Decontamination of Stethoscopes and Assessment of Disinfecting Practices among Physicians in Pakistan: A Quality Improvement Survey

Muhammad Junaid TahirAmeer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan;
Lahore General Hospital, Lahore, Pakistan;

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Musharaf ZamanAmeer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan;
Lahore General Hospital, Lahore, Pakistan;

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Muhammad Saad BabarAmeer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan;
Lahore General Hospital, Lahore, Pakistan;

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Fareeha ImranAmeer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan;
Lahore General Hospital, Lahore, Pakistan;
Postgraduate Medical Institute, Lahore, Pakistan;

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Aasma Noveen AjmalAmeer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan;
Lahore General Hospital, Lahore, Pakistan;
Postgraduate Medical Institute, Lahore, Pakistan;

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Muna MalikAmeer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan;
Lahore General Hospital, Lahore, Pakistan;
Postgraduate Medical Institute, Lahore, Pakistan;
Medical Microbiology and Infectious Diseases Society of Pakistan, Karachi, Pakistan;

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Jalees Khalid KhanAmeer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan;
Lahore General Hospital, Lahore, Pakistan;
Postgraduate Medical Institute, Lahore, Pakistan;

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Irfan UllahKabir Medical College, Gandhara University, Peshawar, Pakistan;
Undergraduate Research Organization, Dhaka, Bangladesh;
Naseer Teaching Hospital, Peshawar, Pakistan;

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Muhammad Sohaib AsgharDow University of Health Sciences–Ojha Campus, Karachi, Pakistan

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ABSTRACT.

The study was conducted to determine bacterial contamination of stethoscopes used by doctors before and after disinfecting with isopropyl alcohol and analyze their practices of disinfecting stethoscopes. Samples from stethoscopes were taken before and after disinfecting with 70% isopropyl alcohol swab with the help of a sterile swab. All swabs were inoculated on Blood and MacConkey agar plates and were examined for growth. Stethoscopes of 78 doctors were sampled which included 45 (58%) males and 33 (42%) females. Before decontamination of diaphragms with isopropyl alcohol, 27 (34.6%) diaphragms had “growth” while 51 (65.4%) had “no growth.” After decontamination with isopropyl alcohol, 5 (6.4%) had “growth” while 73 (93.6%) had “no growth.” The most common microorganism isolated from stethoscopes’ diaphragms was methicillin-resistant Staphylococcus epidermidis (MRSE), that is, 14 out of 78 (17.9%). The survey also evaluated factors associated with contamination of stethoscopes. Most doctors 71(91%) believe that stethoscopes can be a source of infection and 55.1% (N = 43) responded that both diaphragm and bell of stethoscopes can transmit infections. Many doctors (41%, N = 32) reported that “forgetfulness/laziness” was the barrier which they faced regarding stethoscope hygiene followed by “lack of time” (21.8%, N = 17). The contamination rate (66.6%) is highest in those doctors who are using their stethoscopes for 3–5 years. Of them, 30 doctors (38.5%) never decontaminated their stethoscopes among which 17 had growth in their stethoscopes before cleaning with isopropyl alcohol, while three had growth even after decontamination. Most doctors used sanitizer (29.5%) and isopropyl alcohol (25.6%) as cleaning agents.

Author Notes

Address correspondence to Muhammad Sohaib Asghar, Dow University of Health Sciences–Ojha Campus, Karachi, Pakistan. E-mail: sohaib_asghar123@yahoo.com

Disclosure: Data will be shared upon reasonable request from corresponding author, currently not been made available on any online repository.

Authors’ addresses: Muhammad Junaid Tahir, Musharaf Zaman, and Muhammad Saad Babar, Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan, and Lahore General Hospital, Lahore, Pakistan, E-mails: junaid262626@gmail.com, musharafzaman99@gmail.com, and saadsb999@gmail.com. Fareeha Imran, Aasma Noveen Ajmal, and Jalees Khalid Khan, Ameer-ud-Din Medical College, Affiliated with University of Health Sciences, Lahore, Pakistan, Lahore General Hospital, Lahore, Pakistan, and Postgraduate Medical Institute, Lahore, Pakistan, E-mails: fareehaimran536@yahoo.com, noveenaasma@yahoo.com, and jaleeskhalid@hotmail.com. Muna Malik, Ameer-ud-Din Medical College, affiliated with University of Health Sciences, Lahore, Pakistan, Lahore General Hospital, Lahore, Pakistan, and Postgraduate Medical Institute, Lahore, Pakistan, Medical Microbiology and Infectious Diseases Society of Pakistan, Karachi, Pakistan, E-mail: mmkamboh@hotmail.com. Irfan Ullah, Kabir Medical College, Gandhara University, Peshawar, Pakistan, Undergraduate Research Organization, Dhaka, Bangladesh, and Naseer Teaching Hospital, Peshawar, Pakistan, E-mail: irfanullahecp2@gmail.com. Muhammad Sohaib Asghar, Dow University of Health Sciences–Ojha Campus, Karachi, Pakistan, E-mail: sohaib_asghar123@yahoo.com.

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