Introduction
Regardless of their best purposes, health professionals from time to time take action as variables of disease, spreading new infections among their innocent clients. Awareness to basic preventive approaches may considerably lessen illness transmission rates. Regular hand washing remains the sole most vital intervention in infection management. On the other hand, recognizing means to ensure conformity by health professionals remains a confusing problem. Gloves, gowns, and masks have a part in controlling infections, but are frequently used improperly, increasing service costs needlessly. As active microorganisms can be cultured from stethoscopes and white coats, their part in disease transmission remains undefined. There is a better agreement about hygienic insertion methods for intravascular catheters – a frequent cause of illness – and their care. By means of following simple rules acknowledged in this analysis, health professionals may avoid much pointless medical and economic pain to their clients. Hospital acquired infections are of immense concern in hospital settings. Health professionals and their health tools have long been identified to act as variables of infectious diseases. Nosocomial infections in Brazil are the reason for the 45,000 deaths per year and involve an indirect cost of U$ 4.8 billion. This high rate is in part due to the serious conditions to be found in hospital institutions. as a result, all actions towards reducing this death rate are convincing.
The stethoscope is a gadget in regular used by health experts. It is frequently passed from one health practitioners to another and is constantly in direct contact with patients. Disinfection of stethoscopes is a concern that has been ignored (Jones, 1995). The agents most commonly found on stethoscopes are Staphylococcus types, among which are incorporated are strain resistant to antibiotics (Smith, 1996). As a result of the course in acquired immune deficiency syndrome and the raise in the amount of individuals undertaking chemotherapy or immunosuppression therapy, it is necessary that all the causes of contamination be sterilized.
The purpose of the study was to validate the occurrence of bacteria, fungi and yeasts on stethoscope diaphragms and assess their resistance to antimicrobial drugs.
Methods
This study by Maluf et al (2002) was done at the Conjunto Hospitalar de Sorocaba, a tertiary medical hospital. Tests were taken at random from 300 stethoscopes in used by medical staff, medical residents, medical students, nurses and nursing school students, and other divisions of the hospital.
The samples were accumulated from the exterior of the stethoscope diaphragms, by means of a swab dampened in physiological solution. No more than 30 minutes thereafter, it was vaccinated into Brain Heart Infusion media.
The samples were incubated at 36 º C and after 24 or 48 hours, they were vaccinated into blood agar media, MacConkey agar and Sabouraud media (Maluf et al, 2002).
Following the separation of colonies, bacterioscopic and biochemical assays carried out to classify the samplings. Antibiotic sensitivity assays were carried out using the Kirby-Bauer test. The information was consequently examined using the Chi-Squared Test (X2) (Maluf et al, 2002).
Results
Of the sum of 300 stethoscopes tested, 87% were infected. Among the unhygienic stethoscopes, 96% obtained more than one microorganism. The microorganisms secluded were the following: Staphylococcus aureus (n=176), Staphylococcus negative coagulase (n=153), yeasts (n=148), Sarcina (n=64), Bacillus sp (n=45), Streptococcus sp (n=7), Acinetobacter sp (n=2), Pseudomonas putida (n=1) and Klebsiella pnemoniae (n=1) (Maluf et al, 2002).
Maluf et al (2002) proves that there was no essential connection between the most predominant microorganisms and the specialized groups, or whether the user was under training level or not, or the particular hospital division.
In contrast, there was an important dissimilarity between the numerous agents studied in connection to the existence of more than one microorganism on the stethoscope diaphragm. The Staphylococcus aureus, Staphylococcus negative coagulase and Bacillus were notably more frequent (P < 0.0001) (Maluf et al, 2002).
Along with the Streptococcus species, 2 cases of Enterococcus and 4 of Streptococcus viridans were seen. Other microorganisms are cut off in lesser figures but of great clinic significance were: Pseudomonas putida, Klebsiella pneumoniae and Acinectobacter sp (Maluf et al, 2002).
Discussion
Staphylococcus aureus was one of the original among the infectious agent of human beings to become adapted to the progress of antimicrobial matters (Maluf et al, 2002).
The variety of pressure used to microorganisms for them to develop resistance to antimicrobial substances is a result of a numerous of causes. It appears not merely from the use of such drugs in curative or preventative purposes in Medicine and Dentistry, but moreover from their use for Veterinary reasons, in food conservation, in the fight against biological rudiments that are harmful to mankind, and in the process of livestock-raising. In adding up, the free accessibility of these drugs in drugstores and pharmacies is helpful (Dias, 1997).
Acinectobacter sp is at presently the most frequent pathogen linked with multiple resistances to antibiotics in hospital contaminations, particularly in Intensive Care Units. Nonetheless, its occurrence in this study by Maluf et al (2002) was of little importance, with the existence of only one strain.
Conclusion
The stethoscopes obtained have a greater number of contaminations and because of their widespread use among health practitioners; they can be a possible vectors in the distribution of hospital contaminations. It is desirable to frequently clean the diaphragm of the device and its components, in every aspect, by means of a 70% alcohol solution to eradicate the build up of organic substances (Nicodemo, 1996).
A majority of stethoscopes contains potential pathogens. The separation of Gram-negative organisms poses a real threat of distributing potentially severe infections, particularly in the surroundings of intensive care unit. It seems that, the present suggestions of normal disinfection of stethoscopes are not carried out by health practitioners that take part in the study (Maluf et al, 2002).
References
Dias CAG, Kader IA, Azevedo P, et al. (1997). Detection of methycillin-resistant S. aureus (MRSA) in stethoscopes. Rev Microbiol, 28:82-4.
Infections is steel hospital shocked handle medical is steel hospital shocked handle medical. Web.
Jones JS, Hoerle D, Riekse R. (1995). Stethoscopes: a potential vector of infection? Ann Emerg Med;26(3):296-9.
Leão MTC, Monteiro CLB, Fontana CK, et al. (1999). Methicillin-resistant S. aureus (MRSA) Incidência em use steel hospital estetoscópios. JBM; 76(1/2):9 – 14.
Nicodemo AC. (1996). Perfil de sensibilidade de algumas bactérias no complexo Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo e as dificuldades terapêuticas decorrentes. Âmbito Hospitalar, 7(96):13-4.
Smith MA, Mathewson JJ, Ulert IA, Scerpella EG, Ericsson CD. (1996). Contaminated stethoscopes revisited. Arch Intern Med, 156:82-4.
Wright MR, Orr H, Porter C. (1995). Stethoscope contamination in the neonatal intensive care unit. J Hosp Infect, 29:65-8.