Contaminated stethoscopes revisited

Background: Because of their universal use by medical professionals, stethoscopes can be a source of nosocomial infections. Objective: To determine the frequency of contamination of stethoscopes with bacteria and fungi. Methods: Cultures were obtained from 200 stethoscopes from four area hospitals and outpatient clinics in Houston, Tex. The frequency of stethoscope contamination in different groups of hospital personnel and medical settings was determined. We also measured the frequency of antimicrobial resistance of the staphylococcal strains that were isolated. Results: One hundred fifty-nine (80%) of the 200 stethoscopes surveyed were contaminated with microorganisms. The majority of organisms that were isolated were gram-positive bacteria, primarily Staphylococcus species. Fifty-eight percent of the Staphylococcus species that were isolated, including four (17%) of 24 Staphylococcus aureus isolates, were resistant to methicillin. Physicians' stethoscopes were contaminated more often than those of other medical personnel groups (P=.02). Stethoscopes used only in designated areas were contaminated less frequently than stethoscopes belonging to individual medical personnel (P=.01). Although stethoscopes were contaminated in ail areas, stethoscopes from the pediatric medical setting were contaminated less frequently than those from other hospital areas (P=.009). Conclusions: Stethoscope use may be important in the spread of infectious agents, including antimicrobial-resistant strains, and strategies to reduce the contamination of stethoscopes should be developed, We recommend disinfection of stethoscopes or regular use of disposable stethoscope covers.