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Abstract & Commentary
Bacterial Contamination of Health Care Providers' Cell Phones
By David J. Pierson, MD, Editor, Professor, Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, is Editor for Critical Care Alert.
Synopsis: In this study of health care workers' cell phones at a teaching hospital, 44% of 288 phones were culture-positive for potentially infective organisms; doctors' phones were more often positive than those of nurses.
Source: Sadat-Ali M, et al. Bacterial flora on cell phones of health care providers in a teaching institution. Am J Infect Control 2010;38:404-405.
For this study of bacterial contamination of the cell phones of health care workers in a teaching hospital in Saudi Arabia, the investigators swabbed the screen, dialing pad, and sides of the phones and used standard culture techniques. Cell phones of 288 health care providers were cultured. The health care providers' mean age was 34 years, half were women, and they had owned the phones for a mean of 4 months.
One hundred nine (44%) of the phones were culture-positive for organisms that were considered to be potential causes of nosocomial infections. Staphylococcus aureus comprised 33% of the positive cultures, methicillin-resistant staphylococci 7%, S. epidermidis 23%, Streptococcus species 4%, and gram-negative organisms the remainder, including Acinetobacter and Enterococcus in 9% each. Physicians' cell phones were more often positive than those belonging to nurses: 51% vs 42% (P < 0.004). Cultures were positive from 19% of phones whose owners (12% of all health care providers) said they had cleaned them at any time with alcohol swabs provided by the hospital; among the phones of the 76% of health care providers who never cleaned them, 41% were culture-positive (P < 0.05).
This study has two findings of note, neither of them particularly surprising: Contamination of health care workers' cell phones with organisms that can cause hospital-associated infections is common, and the phones' owners seldom clean them despite the ready availability of the means to do so in clinical areas. Cell phones thus join computer keyboards,1,2 computer mice,1 employee identification badges,3 neckties,4 and pens,4,5 among items not physically involved in examining and treating patients, as well as the stethoscopes used by intensivist physicians and ICU nurses,6 on a steadily lengthening list of inanimate objects in the hospital environment that can potentially infect patients.
This and the other cited studies do not definitively establish these objects as sources of clinically important infections in patients. However, they are all linked to something that has been so linked: health care workers' hands. Cell phones and other objects used by clinicians at the bedside most likely become contaminated by the hands of those who use them. Hand hygiene is the cornerstone of infection control in the ICU, and is the most important single measure in preventing the spread of organisms from environment to patient. Whether also regularly cleansing the surfaces of cell phones as well as those of pens, keyboards, and stethoscopes would have a measurable effect on ventilator-associated pneumonia and other hospital-associated infections is technically unknown, but consistent with common sense as well as with the overall goals of infection control in the ICU.