Schmidt Michael G, Tuuri Rachel E, Dharsee Arif, Attaway Hubert H, Fairey Sarah E, Borg Keith T, Salgado Cassandra D, Hirsch Bruce E
Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC.
Department of Emergency Medicine, University of New Mexico, Albuquerque, NM.
Am J Infect Control. 2017 Jun 1;45(6):642-647. doi: 10.1016/j.ajic.2017.01.030. Epub 2017 Mar 13.
Stethoscopes may serve as vehicles for transmission of bacteria among patients. The aim of this study was to assess the efficacy of antimicrobial copper surfaces to reduce the bacterial concentration associated with stethoscope surfaces.
A structured prospective trial involving 21 health care providers was conducted at a pediatric emergency division (ED) (n = 14) and an adult medical intensive care unit located in tertiary care facilities (n = 7). Four surfaces common to a stethoscope and a facsimile instrument fabricated from U.S. Environmental Protection Agency-registered antimicrobial copper alloys (AMCus) were assessed for total aerobic colony counts (ACCs), methicillin-resistant Staphylococcus aureus, gram-negative bacteria, and vancomycin-resistant enterococci for 90 days.
The mean ACCs collectively recovered from all stethoscope surfaces fabricated from the AMCus were found to carry significantly lower concentrations of bacteria (pediatric ED, 11.7 vs 127.1 colony forming units [CFU]/cm, P < .00001) than their control equivalents. This observation was independent of health care provider or infection control practices. Absence of recovery of bacteria from the AMCu surfaces (66.3%) was significantly higher (P < .00001) than the control surfaces (22.4%). The urethane rim common to the stethoscopes was the most heavily burdened surface; mean concentrations exceeded the health care-associated infection acquisition concentration (5 CFU/cm) by at least 25×, supporting that the stethoscope warrants consideration in plans mitigating microbial cross-transmission during patient care.
Stethoscope surfaces fabricated with AMCus were consistently found to harbor fewer bacteria.
听诊器可能成为患者间细菌传播的媒介。本研究旨在评估抗菌铜表面降低与听诊器表面相关细菌浓度的效果。
在一家儿科急诊科(n = 14)和一家位于三级医疗设施中的成人医学重症监护病房(n = 7),对21名医护人员进行了一项结构化前瞻性试验。对听诊器和由美国环境保护局注册的抗菌铜合金(AMCus)制造的传真仪器共有的四个表面,进行了为期90天的需氧菌总数(ACC)、耐甲氧西林金黄色葡萄球菌、革兰氏阴性菌和耐万古霉素肠球菌的评估。
发现从由AMCus制造的所有听诊器表面共同回收的平均ACC所携带的细菌浓度(儿科急诊科,11.7比127.1菌落形成单位[CFU]/平方厘米,P <.00001)显著低于其对照物。这一观察结果与医护人员或感染控制措施无关。从AMCu表面未回收细菌的比例(66.3%)显著高于对照表面(22.4%)(P <.00001)。听诊器共有的聚氨酯边缘是负担最重的表面;平均浓度超过医疗保健相关感染获取浓度(5 CFU/平方厘米)至少25倍,这支持在减轻患者护理期间微生物交叉传播的计划中应考虑听诊器。
一直发现用AMCus制造的听诊器表面携带的细菌较少。