Rao DA , Aman A , Muhammad Mubeen S , Shah A, 2017. Bacterial contamination and stethoscope disinfection practices: a cross-sectional survey of healthcare workers in Karachi, Pakistan. Trop Doct 47: 226–230.
Horiuchi Y, Wettersten N, Vasudevan RS, Barnett O, Maisel AS, 2018. Stethoscope as a vector for infectious disease. Curr Emerg Hosp Med Rep 6: 120–125.
Thapa S, Sapkota LB, 2017. Bacteriological assessment of stethoscopes used by healthcare workers in a tertiary care centre of Nepal. BMC Res Notes 10: 353.
Weldegebreal F, Admassu D, Meaza D, Asfaw M, 2019. Non-critical healthcare tools as a potential source of healthcare-acquired bacterial infections in eastern Ethiopia: a hospital-based cross-sectional study. SAGE Open Med 7: 2050312118822627.
Bansal A, Bhan BD, Gupta K, Purwar S, 2019. To assess the stethoscope cleaning practices, microbial load and efficacy of cleaning stethoscopes with alcohol-based disinfectant in a tertiary care hospital. J Infect Prev 20: 46–50.
Datta P, Kaur M, Rawat S, Gupta V, Chander J, 2018. Stethoscope, “the friendly foe”—a study to evaluate bacterial contamination of stethoscopes and disinfection practices. J Infect Dev Ctries 12: 887–893.
Álvarez JA, Ruíz SR, Mosqueda JL, León X, Arreguín V, Macías AE, Macias JH, 2016. Decontamination of stethoscope membranes with chlorhexidine: should it be recommended? Am J Infect Control 44: e205–e209.
O’Flaherty N, Fenelon L, 2015. The stethoscope and healthcare-associated infection: a snake in the grass or innocent bystander? J Hosp Infect 91: 1–7.
Shiferaw T, Beyene G, Kassa T, Sewunet T, 2013. Bacterial contamination, bacterial profile and antimicrobial susceptibility pattern of isolates from stethoscopes at Jimma University Specialized Hospital. Ann Clin Microbiol Antimicrob 12: 39.
Jenkins IH, Monash B, Wu J, Amin A, 2015. The third hand: low rates of stethoscope hygiene on general medical services. J Hosp Med 10: 457–458.
The Third Hand Available at: https://diskcover.com/the-third-hand/. Accessed March 19, 2022.
AseptiScope A Clean Glove for the Clinician’s Third Hand. Available at: https://infection-control-solutions.medicaltechoutlook.com/vendor/aseptiscope-a-clean-glove-for-the-clinician-s-third-hand-cid-877-mid-85.html. Accessed March 19, 2022.
Martínez J, Macías JH, Arreguín V, Álvarez JA, Macías AE, Mosqueda-Gómez JL, 2017. Isopropyl alcohol is as efficient as chlorhexidine to prevent contamination of blood cultures. Am J Infect Control 45: 350–353.
Jain A, Shah H, Jain A, Sharma M, 2013. Disinfection of stethoscopes: gap between knowledge and practice in an Indian tertiary care hospital. Ann Trop Med Public Health 6: 236.
Fenelon L, Holcroft L, Waters N, 2009. Contamination of stethoscopes with MRSA and current disinfection practices. J Hosp Infect 71: 376–378.
Lavanya J, Jais M, Kumar V, Dutta R, 2013. Accessories of health care workers: a boon or a curse to patients in pediatric ICU and nursery. Int J Curr Microbiol Appl Sci 2: 441–447.
Carugati M et al., 2016. Antistaphylococcal β-lactams versus vancomycin for treatment of infective endocarditis due to methicillin-susceptible coagulase-negative Staphylococci: a prospective cohort study from the International Collaboration on Endocarditis. Antimicrob Agents Chemother 60: 6341–6349.
Melander RJ, Melander C, 2017. The challenge of overcoming antibiotic resistance: an adjuvant approach? ACS Infect Dis 3: 559–563.
Lewis PO, Heil EL, Covert KL, Cluck DB, 2018. Treatment strategies for persistent methicillin‐resistant Staphylococcus aureus bacteraemia. J Clin Pharm Ther 43: 614–625.
Campos-Murguía A, León-Lara X, Muñoz JM, Macías AE, Álvarez JA, 2014. Stethoscopes as potential intrahospital carriers of pathogenic microorganisms. Am J Infect Control 42: 82–83.
Knecht VR, McGinniss JE, Shankar HM, Clarke EL, Kelly BJ, Imai I, Fitzgerald AS, Bittinger K, Bushman FD, Collman RG, 2019. Molecular analysis of bacterial contamination on stethoscopes in an intensive care unit. Infect Control Hosp Epidemiol 40: 171–177.
Kumburu HH, Sonda T, van Zwetselaar M, Leekitcharoenphon P, Lukjancenko O, Mmbaga BT, Alifrangis M, Lund O, Aarestrup FM, Kibiki GS, 2019. Using WGS to identify antibiotic resistance genes and predict antimicrobial resistance phenotypes in MDR Acinetobacter baumannii in Tanzania. J Antimicrob Chemother 74: 1484–1493.
Al-Khafaji Z, Al-Samaree M, 2017. Design of synthetic antimicrobial peptides against resistant Acinetobacter baumannii using computational approach. Int J Pharm Sci Res 8: 2033–2039.
Malik M, Malik MI, Akhtar FK, 2019. Microbiological profile and antibiogram of lower respiratory tract infections at Lahore General Hospital, Lahore. J Postgrad Med Inst 33: 23–29.
Daoudi A, El IdrissiSlitine N, Bennaoui F, Alaoui M, Soraa N, Maoulainine FM, 2017. Study of bacterial contamination of mobile phones and stethoscopes in neonatal intensive care unit. Int J Pediatr 5: 6139–6142.
Ahmed K, Shaikh S, Rehman R, Ali SM, 2018. Frequency of awareness and practice of stethoscope hygiene with regards to guideline among medical students, residents and doctors in Karachi. J Bahria Univ Med Dental Coll 8: 31–34.
Bošković S, Sharawy K, Rodriguez AS, Savić B, 2015. Bacterial contamination of stethoscopes in university hospitals: multicenter study. Medicinskipodmladak 66: 55–60.
Centers for Disease Control and Prevention, National Center for Preparedness, Detection, and Control of Infectious Diseases, Division of Healthcare Quality Promotion Guideline for Disinfection and Sterilization in Healthcare Facilities—2008. Available at: https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html. Accessed December 12, 2008.
Boulée D, Kalra S, Haddock A, Johnson TD, Peacock WF, 2019. Contemporary stethoscope cleaning practices: what we haven’t learned in 150 years. Am J Infect Control 47: 238–242.
Longtin Y, Schneider A, Tschopp C, Renzi G, Gayet-Ageron A, Schrenzel J, Pittet D, 2014. Contamination of stethoscopes and physicians’ hands after a physical examination. Mayo Clin Proc 89: 291–299.
Whittington AM, Whitlow G, Hewson D, Thomas C, Brett SJ, 2009. Bacterial contamination of stethoscopes on the intensive care unit. Anaesthesia 64: 620–624.
Muniz J, Sethi RK, Zaghi J, Ziniel SI, Sandora TJ, 2012. Predictors of stethoscope disinfection among pediatric health care providers. Am J Infect Control 40: 922–925.
Bukharie HA, Al-Zahrani H, Rubaish AM, Abdulmohsen MF, 2004. Bacterial contamination of stethoscopes. J Family Community Med 11: 31–33.
Uneke CJ, Ogbonna A, Oyibo PG, Onu CM, 2010. Bacterial contamination of stethoscopes used by health workers: public health implications. J Infect Dev Ctries 4: 436–441.
Lee R, Choi SM, Jo SJ, Han S, Park YJ, Choi MA, Kong BK, 2021. A quasi-experimental study on stethoscopes contamination with multidrug-resistant bacteria: its role as a vehicle of transmission. PLOS One 16: e0250455.
Vasudevan R, Shin JH, Chopyk J, Peacock WF, Torriani FJ, Maisel AS, Pride DT, 2020. Aseptic barriers allow a clean contact for contaminated stethoscope diaphragms. Mayo Clin Proc Innov Qual Outcomes 4: 21–30.
Amin A, 2021. Keeping the stethoscope, the clinician’s third hand, clean. Infect Control Today 25. Available at: https://www.infectioncontroltoday.com/view/keeping-the-stethoscope-the-clinician-s-third-hand-clean. Accessed March 19, 2022.
Vasudevan RS, Horiuchi Y, Torriani FJ, Cotter B, Maisel SM, Dadwal SS, Gaynes R, Maisel AS, 2020. Persistent value of the stethoscope in the age of COVID-19. Am J Med 133: 1143–1150.
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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.
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: email@example.com, firstname.lastname@example.org, and email@example.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: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. 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: email@example.com. Irfan Ullah, Kabir Medical College, Gandhara University, Peshawar, Pakistan, Undergraduate Research Organization, Dhaka, Bangladesh, and Naseer Teaching Hospital, Peshawar, Pakistan, E-mail: firstname.lastname@example.org. Muhammad Sohaib Asghar, Dow University of Health Sciences–Ojha Campus, Karachi, Pakistan, E-mail: email@example.com.