A prospective, randomised, double-blind study of comparative efficacy of immediate versus daily cleaning of stethoscope using 66% ethyl alcohol.

The Department of Paediatrics, Seth G.S. Medical College & K.E.M. Hospital, Parel, Mumbai-400 012, India.
Indian Journal of Medical Sciences (Impact Factor: 1.67). 11/2004; 58(10):423-30.
Source: PubMed

ABSTRACT Studies have demonstrated frequent contamination of stethoscope and usefulness of different disinfectants. Albeit, studies on the precise mode of cleaning and frequency of cleaning are lacking. This study was carried out to determine efficacy of 66% ethyl alcohol as disinfectant, rate of recontamination without cleaning and benefits of daily versus immediate cleaning.
Prospective, randomised, double blind study of 100 stethoscopes. Four cultures were obtained: before cleaning (Group A), immediately after cleaning with 66% ethyl alcohol (Group B), at the end of 4 days without cleaning (Group C) and at the end of 4 days after cleaning once a day (Group D). Samples were analysed using standard microbiological methods and Colony-forming unit (CFU) count and residual microorganism was computed for all the positive cultures. Medical staff was asked about the cleaning practices. Statistical analysis was carried out using 95% confidence interval and Chi-square test.
90% of the stethoscopes were contaminated with one or more microorganisms. Immediate cleaning and daily cleaning were associated with a significant reduction in the rate of contamination to 28% and 25% respectively. CFU count in groups B and D dropped to less than 10 in 75% and 84.7%, while the mean residual rates were 5.2% and 3.65% respectively. Groups B and D showed no statistically significant difference in terms of efficacy of disinfection.
66% ethyl alcohol is an effective disinfectant. The effects of immediate cleaning and cleaning once a day on residual flora on the diaphragm of stethoscope is comparable.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Stethoscopes are one of the most commonly used medical devices and have been reported to be potential sources of hospital acquired infections. In this study, we aimed to find out the bacterial contamination of stethoscopes used by health-care staff. Swab samples were taken from the surface of the diaphragm of the stethoscopes used by health personnel in four hospitals including three second-line and one third-line health care institution in Turkey. The samples were inoculated onto bacteriological and mycological media. For identification of the microorganisms, conventional methods and Vitek2 (Biomérieux) were performed. Swab samples were taken from 121 stethoscopes. We found bacterial and fungal contamination on 92 (76%) of the stethoscopes. 15 out 90 (16.3%) had potential pathogens including methicillin susceptible Staphylococcus aureus (5), methicillin resistance Staphylococcus aureus (4), Escherichia coli (3), Acinetobacter baumannii, Acinetobacter haemolyticus and Enterococcus spp. Of the 121 health-care persons, only 61 regularly cleaned their stethoscopes by various disinfectants. The statistical difference between the two groups in terms of pathogen and microorganism isolation was not determined (p>0.05). Although stethoscopes are uncritical medical devices, they could contain pathogen microorganisms and they might be a potential source of hospital acquired infections.
  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The Hand Hygiene Liaison Group and Epic Projects (Pratt et al., J Hosp Infect 47[Suppl A], 2001) have asked specifically for further trials of educational interventions to improve hand decontamination compliance and infection control in the hospital setting. This study investigates the efficacy of a 'clean practice protocol' (CPP), derived from international guidelines, to improve compliance of infection-control practices by surgical teams in a large UK teaching hospital. The key infection-control activities were summated to form the CPP presented here. An undisclosed infection-control audit of consultant-led ward-rounds from breast, gastrointestinal, vascular, urological, and intensive care departments was performed. The audit results were presented to the surgical teams, after which an education/awareness program was implemented. A repeat undisclosed audit was performed 3 months later. In both audits, infection-control activities were recorded together with consultation time and any patient infective complications. The surgical teams performed as follows in the initial audit: hand decontamination (28% of consultations), correct use of gloves (2%), instrument cleaning (0%), garment contamination (49%), and notes contamination (34%). Introduction of the CPP education program significantly improved hand decontamination to 87% (p < 0.0001), the correct use of gloves/aprons to 50% (p < 0.0001), and overall infection-control practice from 63% to 89% (p < 0.05). The introduction of the CPP significantly improved compliance of hand decontamination, correct usage of gloves and aprons, and overall infection-control in a large teaching hospital. The CPP is a highly effective auditing and educational tool that can be readily adapted for use in hospitals globally to monitor and improve infection-control practices.
    Infection 02/2009; 37(1):34-8. DOI:10.1007/s15010-008-8005-3 · 2.86 Impact Factor
Show more