Stethoscope as a Vector for Infectious Disease
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Purpose of Review
To discuss the current status of the stethoscope as a vector for infection and possible interventions to promote stethoscope disinfection.
Anywhere from 70 to 100% of stethoscopes are contaminated after a physical examination with bacterial counts of stethoscopes comparable to those of the physician’s dominant hand. Disinfection with alcohol agents can reduce the number of pathogens and risk of transmission, which is recommended by guidelines. However, only 0–11% of healthcare providers disinfected their stethoscope before patient contact and 0–24% disinfected after the contact. The effectiveness of educational programs with visual reminders and supplying disinfectants is uncertain.
Stethoscopes commonly harbor bacteria and can serve as a vector for transmission of infectious diseases. Only a minority of healthcare providers actually disinfect their stethoscope. There is a clear need for strategies to alter physicians’ recognition and behavior for stethoscope disinfection.
KeywordsStethoscope Healthcare-associated infection Infection control Disinfection
Compliance with Ethical Standards
Conflict of Interest
Yu Horiuchi, Nicholas Wettersten, Rajiv S. Vasudevan, Olga Barnett, and Alan S. Maisel declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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- 1.Chow SL, Maisel AS, Anand I, Bozkurt B, de Boer RA, Felker GM, et al. Role of biomarkers for the prevention, assessment, and management of heart failure: a scientific statement from the American Heart Association. Circulation. 2017;135(22):e1054–e91. https://doi.org/10.1161/CIR.0000000000000490.CrossRefPubMedGoogle Scholar
- 3.Etiology SI. Concept and prophylaxis of childbed fever: University of Wisconsin Press; 1983.Google Scholar
- 14.• Gupta N, Gandham N, Misra R, Jadhav S, Ujgare M, Vyawahare C. The potential role of stethoscopes as a source of nosocomial infection. Med J Dr DY Patil Vidyapeeth. 2014;7(2):156–9. https://doi.org/10.4103/0975-2870.126323. This study reported the degree of contamination of stethoscopes in different hospital wards and intensive care units of a tertiary care teaching hospital. CrossRefGoogle Scholar
- 26.•• Longtin Y, Schneider A, Tschopp C, Renzi G, Gayet-Ageron A, Schrenzel J, et al. Contamination of stethoscopes and physicians’ hands after a physical examination. Mayo Clin Proc. 2014;89(3):291–9. https://doi.org/10.1016/j.mayocp.2013.11.016. This study showed the contamination level of the stethoscope is comparable to the physician’s dominant hand. CrossRefPubMedGoogle Scholar
- 35.Merlin MA, Wong ML, Pryor PW, Rynn K, Marques-Baptista A, Perritt R, et al. Prevalence of methicillin-resistant Staphylococcus aureus on the stethoscopes of emergency medical services providers. Prehosp Emerg Care. 2009;13(1):71–4. https://doi.org/10.1080/10903120802471972.CrossRefPubMedGoogle Scholar
- 37.Centers for Disease CaP. Guideline for disinfection and sterilization in healthcare facilities. 2008.Google Scholar
- 38.Gerding DN, Muto CA, Owens RC, Jr. Measures to control and prevent Clostridium difficile infection. Clin Infect Dis 2008;46 Suppl 1:S43–S49. doi: https://doi.org/10.1086/521861.
- 40.Kalra S, Boulee D, Haddock A, Peacock W. 420 standard of care for cleaning stethoscopes before patient evaluations. Ann Emerg Med. 70(4) S164-S5. https://doi.org/10.1016/j.annemergmed.2017.07.299.
- 45.Gastmeier P, Groneberg K, Weist K, Ruden H. A cluster of nosocomial Klebsiella pneumoniae bloodstream infections in a neonatal intensive care department: identification of transmission and intervention. Am J Infect Control. 2003;31(7):424–30. https://doi.org/10.1067/mic.2003.70.CrossRefPubMedGoogle Scholar