Bacterial Contamination of Stethoscopes with Antimicrobial Diaphragm Covers

ISSUE: Stethoscopes in the hands of most health care disciplines can harbor harmful microorganisms. A relatively new product has come into use in the hospital setting in the effort to combat organisms that cause infections. Saint Alphonsus (SARMC) wanted to find out if this product would help decrease nosocomial infections. PROJECT: Antimicrobial diaphragm covers (≥2 per individual) with the manufacturersʹ recommendations about cleaning and routine changing of covers were distributed to a mixed group of clinicians working in a large medical/surgical/trauma intensive care unit (ICU). All clinicians were instructed that they may be randomly selected to participate in a study. The study included culturing the healthcare workers stethoscope and a short survey regarding the workers practice of routine cleaning and changing of their stethoscope cover (if given the antimicrobial stethoscope cover). During the study period clinicians were randomly selected from the ICU staff (MDʹs RNʹs, RTʹs, or Other) for culture of stethoscope diaphragms (with and without diaphragm covers). Cultures were obtained by pressing the diaphragm surface for five seconds on mannitol agar plate and incubating the plate aerobically for forty-eight hours. At the time of culture, each clinician was asked to complete a short written survey. Each clinician indicated the duration of use of their antimicrobial cover (if applicable), how often they cleaned their stethoscope, and what agent they used for cleaning the stethoscope. RESULTS: 74 stethoscopes were cultured (37 with covers, 37 without covers). One hundred percent of the stethoscopes cultured were contaminated. Colony counts were significantly lower for uncovered stethoscope diaphragms averaging 71.4 colony counts compared to 246.5 colonies on covered stethoscopes. LESSONS LEARNED: In summary, the antimicrobial diaphragm covers appeared to offer no advantage.