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Indian Journal of Medical Microbiology, Vol. 27, No. 3, July-September, 2009, pp. 279-281 Correspondence Bacterial contamination of mobile phones of health care workers Datta P, Rani H, Chander J, Gupta V Department of Microbiology, GMCH-32, Chandigarh - 160 030 Date of Submission: 04-Sep-2008 Code Number: mb09084 PMID: 19584520 Dear Editor, Nosocomial infections continue to pose risks of increased mortality and morbidity in patients. The hands of healthcare workers (HCWs) play an important role in transmission of this infection. Over the past decade, mobile phones (MPs) have become an essential accessory in our social and professional life. The mobile phones of HCWs harbour many harmful pathogens which serve as a reservoir for nosocomial infections. [1] Thus the etiological agents of nosocomial infection have found a significant, unique and perfect way to spread in our hospital. In this study we investigated the rate of bacterial contamination of mobile phones of HCWs employed in our tertiary healthcare teaching hospital, located in Chandigarh, India. We compared this contamination rate with that of our control group. Attendants of patients in OPDs, not working in any healthcare setting, formed our control group. Random sampling of 200 HCWs, from December 2007 to February 2008,, was carried out. Various areas of the hospital included were OPDs, wards, ICUs, CCU, burn wards and laboratories. A sterile swab moistened with sterile demineralised water was rotated on the sides and over the keypad of mobile phone. The swabs were immediately inoculated and streaked onto five per cent sheep blood agar and eosin methylene blue agar (Hi-Media, India). Plates were incubated aerobically at 37˚C for 24 hours. Isolated organisms was processed according to colony morphology and gram stain. Bacteria were identified according to standard protocol (Mackie and McCartney). Tests for identification of gram positive cocci included catalase, Oxidative/ Fermentative test, anaerobic mannitol fermentation and coagulase production. Oxacillin sensitivity of Staphylococcus aureus was carried out by using oxacilin disk diffusion test. [2] In total, 200 HCWs, 97 doctors, 55 nurses, 42 laboratory technicians and 6 safai karamcharis were included. Area wise distribution of test sample were as follows; 71 from OPDs [paediatrics (9), gynaecology (10), medicine (11), dermatology (4), ophthalmology (10), pulmonary madicine (5), psychiatry (3), surgery (8), otolaryngology (4) and dental (7)], 55 from wards [paediatrics (5), gynaecology (7), labor room (6), medicine (8), ophthalmology (4), pulmonary medicine (5), surgery (5), burn (7), orthopaedics (5) and blood bank (3)], 21 from laboratories (microbiology, pathology, biochemistry) and 53 from high risk areas [ICU (13), CCU(3), PICU(9) and emergency (28)]. Bacteriological analysis revealed that of the 200 MPs sampled, 144 (72%) were contaminated with bacteria. Among 144 bacterial isolates from mobile phones, the following number and type of bacteria were isolated: 26 methicillin resistant Staphylococcus aureus (MRSA), 46 methicillin sensitive Staphylococcus aureus (MSSA), 19 coagulase negative Staphylococcus (CONS), 4 Micrococcus spp., 2 viridans Streptococci and 47 aerobic spore bearers. Hence, 72(36%) of the mobile phones were contaminated with bacteria which are well known to be associated with hospital associated infections i.e. Staphylococcus aureus. These were defined as significant isolates i.e. the organisms commonly associated with nosocomial infections. [1] MRSA was present on 18% mobile phones of HCWs in our health care settings. These deadly pathogens were found on the mobile phones of 12 doctors, six nurses, six laboratory attendants and two safai karamchari [Figure - 1]. Area wise distribution of MRSA showed; 12 from HCWs working in OPDs, six from laboratories, five from wards, two from emergency and one from nursery. A total of 50 control samples were taken. Five swabs from control group showed growth of Coagulase-negative Staphylococcus and the remaining were sterile. Gram-negative bacteria and Enterococcus species , surprisingly, were not isolated from any of the mobile phones. This could be because the hands of HCWs at our hospital setting are predominantly colonized with Staphylococci . Similar studies conducted by Brady RRW et al , UK and Karabay O et al ., Turkey suggested that the isolation of gram negative bacilli from the mobile phones was less i.e. 4.76% and 7.2% respectively. [3],[4] Khivsara et al .reported 40% contamination of mobile phones by Staphylococcus and MRSA from HCWs working in a Mangalore hospital. [5] In a similar study from Turkey hospital, only 9% of mobile phones sampled showed contamination by bacteria associated with nosocomial infections. [4] Similarly, Brady et al . said 14% of mobile phones showed growth of bacteria known to cause nosocomial infection. [3] Comparing these studies with our study, a higher percentage (36%) of mobile phones sampled was contaminated and 18% HCWs had MRSA growing on their mobile phones and if we look at the rate of MRSA isolates amongst skin and soft tissue infections at our institute then it is about 23.08%. [6] This study highlights mobile phones as a potential threat in infection control practices and could exaggerate rate of healthcare - associated infections. Mobile phones were found to carry these bacteria because count of these bacteria increases in high temperature and our phones are ideal breeding sites for these microbes as they are kept warm and snug in our pockets and handbags. Also, there are no guidelines for the care, cleaning and restriction of mobile phones in our health care settings. Hence, in a country like ours, mobile phones of HCWs play an important role in transmission of infection to patients, which can increase the burden of heath care. In conclusion, it can be said that hand hygiene is greatly overlooked and under-emphasized in health care settings. Simple measures such as increasing hand hygiene and regular decontamination of mobile phones with alcohol disinfectant wipes may reduce the risk of cross-contamination caused by these devices. [3],[7] References
Copyright 2009 - Indian Journal of Medical Microbiology The following images related to this document are available:Photo images[mb09084f1.jpg] |
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