Are we aware how contaminated our mobile phones with nosocomial pathogens?

Reservoirs of Nosocomial Pathogens in Intensive Care Units: A Systematic Review

Background

Nosocomial pathogens are known to exacerbate morbidity and mortality in contemporary critical healthcare. Hospital fomites, which include inanimate surfaces, have been identified as "breeding grounds" for pathogens that cause nosocomial infections. This systematic review aimed to deliver incisive insights on nosocomial pathogens in intensive care units (ICUs) and the role of fomites as potential reservoirs for their transmission.

Method

An extensive exploration of electronic databases, including PubMed and Scopus, from 1990 to 2023, was carried out between 25th and 29th May 2023, per standard PRISMA guidelines. Information were extracted from articles that reported on fomites in the ICU. Studies that did not quantitatively report the fomite contamination, and those that exclusively took samples from patients in the ICU were excluded from the analysis.

Results

About 40% of the total samples collected on fomites from all the studies yielded microbial growth, with species of Staphylococcus being the most predominant. Other prevalent microbes were Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Candida spp., Enterococcus sp., and Enterobacter sp. The neonatal intensive care unit (NICU) had the highest proportion of contaminated fomites. Among known fomites, the sphygmomanometer exhibited a 100% detection rate of nosocomial pathogens. This included E. aerogenes, Staphylococcus aureus, coagulase-negative Staphylococci (CoNS), E. coli, and K. pneumoniae. Multidrug-resistant (MDR) bacteria, such as methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococci (VRE), extended-spectrum beta-lactamase (ESBL)-producing E. coli, and MDR Pseudomonas aeruginosa were commonly isolated on fomites in the ICUs.

Conclusion

Many fomites that are readily used in patient care in the ICU harbour nosocomial pathogens. The most common fomite appeared to be mobile phones, sphygmomanometers, and stethoscopes, with Staphylococcus being the most common contaminant. Consequently, the need for rigorous disinfection and sterilization protocols on fomites in the ICU cannot be overemphasized. Additionally, heightened awareness on the subject among health professionals is crucial to mitigating the risk and burden of nosocomial infections caused by drug-resistant bacteria.

Bacterial Colonization of Mobile Phones: Myth or Reality

Introduction Bacteria tend to persist on mobile phones for longer durations causing hospital-acquired infections. This is primarily because mobile phones have become an extended hand to healthcare workers due to their unavoidable utilization and the lack of sanitization after use in wards. Methods A questionnaire was used to assess the usage and disinfection practices of mobile phones among medical students regularly attending the wards of a teaching hospital. Culture was done to assess the presence of bacteria and their resistance to antibiotics. Three sterile cotton swabs were performed for each mobile phone. If growth was present, then a culture smear was made, and the type of bacteria was assessed. Participants received subsequent education on the disinfection of phones according to standard disinfection protocol. The main objective of the study was to determine the presence of bacteria on students' mobile phones and its resistance to antibiotics. Results A total of 103 medical students took part in the study, which included 51 males and 52 females. It was found that all the students used their mobile phones at all times in wards and 43% of them carried their phones to washrooms. Out of all the students surveyed, only 23% of students had regularly disinfected their phones. Bacteria were present on all mobile phones sampled. Among these, 98.05% had Gram-positive bacteria, 82.52% had Gram-negative bacilli, 33.98% had Bacillaceae, and 8.73% had vancomycin-resistant enterococcus (VRE). Among participants who did not disinfect their phones, 95.89% and 97.59% had methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA), respectively. Conclusion Following standard disinfection protocols is the need of the hour to reduce hospital-acquired infections.

Preventing Multidrug-Resistant Bacterial Transmission in the Intensive Care Unit with a Comprehensive Approach: A Policymaking Manual

Patients referred to intensive care units (ICU) commonly contract infections caused by multidrug-resistant (MDR) bacteria, which are typically linked to complications and high mortality. There are numerous independent factors that are associated with the transmission of these pathogens in the ICU. Preventive multilevel measures that target these factors are of great importance in order to break the chain of transmission. In this review, we aim to provide essential guidance for the development of robust prevention strategies, ultimately ensuring the safety and well-being of patients and healthcare workers in the ICU. We discuss the role of ICU personnel in cross-contamination, existing preventative measures, novel technologies, and strategies employed, along with antimicrobial surveillance and stewardship (AMSS) programs, to construct effective and thoroughly described policy recommendations. By adopting a multifaceted approach that combines targeted interventions with broader preventive strategies, healthcare facilities can create a more coherent line of defense against the spread of MDR pathogens. These recommendations are evidence-based, practical, and aligned with the needs and realities of the ICU setting. In conclusion, this comprehensive review offers a blueprint for mitigating the risk of MDR bacterial transmission in the ICU, advocating for an evidence-based, multifaceted approach.

Phenotypic and molecular characterization of Staphylococcus aureus from mobile phones in Nigeria

The presence of Staphylococcus aureus, a normal human flora on cellphones of different professionals in Ile-Ife was investigated with a view to determining their antibiotic susceptibility profile and nature of resistance and virulence genes. One hundred swab samples were collected aseptically from mobile phones of various users based on their profession. Surfaces of the mobile phones were swabbed and the streak plate method was used to isolate colonies showing characteristic golden yellow on mannitol salt agar plates. These isolates were further identified using standard microbiological methods. The antibiotic susceptibility of the isolates was determined using Kirby-Bauer's disk diffusion technique. Molecular detection of nuc, mecA and pvl genes in some isolates was carried out by polymerase chain reaction technique. All the 36 isolates obtained in this study were 100% resistant to amoxicillin and augmentin; the isolates also displayed 55.6%, 44.4% and 41.7% resistance to ceftriazone, erythromycin and chloramphenicol, respectively. Based on resistance to oxacillin, prevalence of methicillin resistant Staphylococcus aureus (MRSA) was 11.1%. Only one S. aureus was positive for plasmid analysis. MecA gene was genetically confirmed in four (4) out of the 16 suspected phenotypic MRSA strains, nuc gene was confirmed in all 28 isolates investigated, while there was no pvl gene in the strains investigated. Mobile phones harbor multiple antibiotics resistant S. aureus, which are responsible for important diseases in humans and could be difficult to manage with antibiotics thereby posing serious health risks.

Knowledge, Attitudes, and Practices of Finnish Dairy Farmers on Cryptosporidiosis

Calf-mediated zoonotic cryptosporidiosis is an emerging occupational health risk among Finnish dairy farmers. We studied farmers' knowledge, attitudes, and practices (KAP) regarding cryptosporidiosis to reveal possible weaknesses, which might increase the risk of zoonotic infection. KAP study was carried out as a cross-sectional questionnaire survey (n = 243). A total of 400 cryptosporidiosis-negative and 138 cryptosporidiosis-positive dairy farms, with more than 50 cows, were invited to participate in the study. The response rate was 45%. Half (49%) of the respondents had adequate knowledge concerning zoonotic cryptosporidiosis. Knowledge score was associated with age (p < 0.01), level of education (p < 0.01), and cryptosporidiosis status of the farm (p < 0.01). Though most respondents had favorable attitudes, one-third (32.5%) had poor zoonotic transmission prevention practices. Use of a personal mobile device was the most common risky practice (90%) performed daily in the cowhouse. Most respondents (93%) reported gaining information about infectious diseases in animals from more than two information sources. Veterinarians were the most mentioned source (n = 228), whereas primary care physicians were among the least common sources (n = 16). Having favorable attitudes towards the prevention of zoonotic cryptosporidiosis was common. However, shortages in knowledge and several risky practices were identified in both cryptosporidiosis positive and negative farms. The role of the occupational health sector should be strengthened in work-related zoonotic disease prevention and may require further education of the personnel. A one-health approach to control zoonotic diseases is recommended.

Timing errors and temporal uncertainty in clinical databases-A narrative review

A firm concept of time is essential for establishing causality in a clinical setting. Review of critical incidents and generation of study hypotheses require a robust understanding of the sequence of events but conducting such work can be problematic when timestamps are recorded by independent and unsynchronized clocks. Most clinical models implicitly assume that timestamps have been measured accurately and precisely, but this custom will need to be re-evaluated if our algorithms and models are to make meaningful use of higher frequency physiological data sources. In this narrative review we explore factors that can result in timestamps being erroneously recorded in a clinical setting, with particular focus on systems that may be present in a critical care unit. We discuss how clocks, medical devices, data storage systems, algorithmic effects, human factors, and other external systems may affect the accuracy and precision of recorded timestamps. The concept of temporal uncertainty is introduced, and a holistic approach to timing accuracy, precision, and uncertainty is proposed. This quantitative approach to modeling temporal uncertainty provides a basis to achieve enhanced model generalizability and improved analytical outcomes.

Antibiotic Susceptibility Patterns of ESβL Producers Isolated from the Mobile Phones

Mobile phones have become an indispensable part of human lives for communication, education, and entertainment activities. This study aims to evaluate the diversity pattern of bacterial contaminants on mobiles and to check antibiotic resistance profiles in 105 samples. The study revealed a contamination of 51% in men and 49% in women, the highest in the 21- to 30-year age group, evidencing the extreme use of mobiles by teenagers. The study observed Gram-negative bacteria (63%) versus Gram-positive bacteria (37%). Overall, Gram-negative bacterial isolates showed the highest sensitivity to antibiotic nitrofurantoin (90%) and the lowest in ampicillin (35%). Gram positive has highest incidence of sensitivity towards tigecycline (100%) and lowest in cefoxitin (20%). ESβL producers were found to be 21.0% and highest being in Klebsiella oxytoca (35%) followed by Klebsiella pneumonia (31%). Staphylococcus pseudintermedius and Staphylococcus capitis have been identified on the mobile phones for the very first time. Interestingly, some soil microbes were also isolated and unfortunately found to have some antibiotic resistance like Raoultella ornithinolytica and Sphingomonas paucimobilis. The results revealed that mobiles were contaminated with multidrug-resistant (MDR) pathogens, and this study also showed that few of the saprophytic soil strains have antibiotic resistance, which can be an alarming situation that needs to be addressed.

Isolation and Identification of Pathogenic Microorganisms associated with Electronic Devices from Healthcare Professionals in and around Chennai

Electronic devices such as mobile phones, Bluetooth devices, electronic tabs, laptops, earphones and biometrics have all become an element in both the personal and professional life of human race. These electronic devices are in intense contact with us every day which might result in contamination of these devices and increase in the microbial load. Nowadays, the devices have become multiple interfaces leading to increase in the bacterial load and also the heat generated by various users make the devices a suitable breeding ground for the pathogenic organisms. The study is aimed at isolating and identifying microorganisms from electronic devices of health care professionals in and around Chennai. The study group was separated into the use of electronic devices like mobile phones, biometrics, laptops and electronic tabs utilized by doctors, nurses, interns and lab technicians. The samples were collected aseptically using sterile cotton swabs and transported to laboratory where isolation and identification of microbes were done using standard microbial testing. Total of 75 samples were collected in which 100% of the total sample were contaminated with heavy load of microorganisms. The species identified from the electronic devices were Pseudomonas sp., Bacillus sp., Streptococcus sp., Protease sp in abundance which is associated with pathogenic infections. Antibiotic sensitivity showed resistance against commercially available antibiotics on testing. Awareness among the health care professionals on personal hygiene and safe usage of the devices away from contamination are the possible ways to stay away from infectious pathogens.

Synthesis and Investigation of Antibacterial Activity of Thin Films Based on TiO2-Ag and SiO2-Ag with Potential Applications in Medical Environment

Multiple antibiotic resistance has now become a major obstacle to the treatment of infectious diseases. In this context, the application of nanotechnology in medicine is a promising alternative for the prevention of infections with multidrug-resistant germs. The use of silver as a powerful antibacterial agent has attracted much interest. TiO2 and SiO2 thin films enhanced with Ag particles have been developed with the aim of maintaining the transparency of the polymer films. Antibacterial activity was evaluated for a Gram-negative species-Escherichia coli-in concentrations of 105 and 104 CFU/mL in different conditions-activation by UV irradiation, single layer and double layer. Increased antibacterial efficacy of TiO2-deposited foil was found for the tests that had been exposed to UV activation. In the case of bilayer tests, the efficiency was higher compared to those in a single layer, as the contact surface between the films and the bacterial suspension increased. Films can be used as a potential method to limit bacterial growth on hospital surfaces, such as telephone screens and medical equipment, given their optimized characteristics and proven antibacterial efficacy.

eDNA Inactivation and Biofilm Inhibition by the PolymericBiocide Polyhexamethylene Guanidine Hydrochloride (PHMG-Cl)

The choice of effective biocides used for routine hospital practice should consider the role of disinfectants in the maintenance and development of local resistome and how they might affect antibiotic resistance gene transfer within the hospital microbial population. Currently, there is little understanding of how different biocides contribute to eDNA release that may contribute to gene transfer and subsequent environmental retention. Here, we investigated how different biocides affect the release of eDNA from mature biofilms of two opportunistic model strains Pseudomonas aeruginosa ATCC 27853 (PA) and Staphylococcus aureus ATCC 25923 (SA) and contribute to the hospital resistome in the form of surface and water contaminants and dust particles. The effect of four groups of biocides, alcohols, hydrogen peroxide, quaternary ammonium compounds, and the polymeric biocide polyhexamethylene guanidine hydrochloride (PHMG-Cl), was evaluated using PA and SA biofilms. Most biocides, except for PHMG-Cl and 70% ethanol, caused substantial eDNA release, and PHMG-Cl was found to block biofilm development when used at concentrations of 0.5% and 0.1%. This might be associated with the formation of DNA–PHMG-Cl complexes as PHMG-Cl is predicted to bind to AT base pairs by molecular docking assays. PHMG-Cl was found to bind high-molecular DNA and plasmid DNA and continued to inactivate DNA on surfaces even after 4 weeks. PHMG-Cl also effectively inactivated biofilm-associated antibiotic resistance gene eDNA released by a pan-drug-resistant Klebsiella strain, which demonstrates the potential of a polymeric biocide as a new surface-active agent to combat the spread of antibiotic resistance in hospital settings.

Exploring infection prevention practices in home-based nursing care: A qualitative observational study

BACKGROUND

Home-based nursing care continues to expand, delivering care to increasingly older clients with multiple, chronic and complex conditions that require the use of additional and more numerous invasive medical devices. Therefore, the prevention of infections poses a challenge for nurses, professional caregivers and clients.

OBJECTIVE

This article explores infection prevention practices and related behavioural factors in both nurses and clients to identify barriers and facilitators of infection prevention practices in home-based nursing care.

DESIGN

A qualitative, exploratory design.

SETTING

Four healthcare organisations providing home-based nursing care in the Netherlands.

METHODS

Participant observations were used as the main source of data collection complemented with focus group discussions and semi-structured interviews.

PARTICIPANTS

Participant observations: 16 nurses, three professional caregivers and 80 clients. Semi-structured interviews: 11 clients. Focus group discussions: 15 nurses and four professional caregivers.

RESULTS

A total of 87 unique care delivery situations were observed for 55 h, complemented with three focus group discussions and 11 individual semi-structured client interviews. Infection prevention practices in home-based nursing care appeared to be challenged by 1. The specific context or environment in which the care occurred, which is more autonomous, less structured, less controlled and less predictable than other care settings; 2. Suboptimal and considerable variation in professional performance concerning the application of hand hygiene and the proper use of personal protective equipment such as face masks, barrier gowns and disposable gloves; 3. Extensive use in and outside the client's surroundings of communication devices that are irregularly cleaned and tend to interrupt nursing procedures; and 4. Inadequate organisational support in the implementation and evaluation of new information or policy changes and fragmentation, variation and conflicting information regarding professional guidelines and protocols.

CONCLUSIONS

From a first-hand observational viewpoint, this study showed that the daily practice of infection prevention in home-based nursing care appears to be suboptimal. Furthermore, this research revealed considerable variation in the work environment, the application of hand hygiene, the proper use of personal protective equipment, the handling of communication devices and organisational policies, procedures and support. Finally, the study identified a number of important barriers and facilitators of infection prevention practices in the work environment, professional and team performance, clients and organisations.

Mobile phones of anesthesiologists as reservoirs of nosocomial bacteria in a quaternary teaching hospital: an observational study

BACKGROUND

Mobile phones in hospital settings have been identified as an important source of cross-contamination because of the low frequency with which mobile phones are cleaned by health workers and cyclical contamination of the hands and face. The aim of this study was to investigate whether the mobile phones of the anesthesia team at a teaching hospital are potential reservoirs of nosocomial bacteria. In addition, differences in device sanitization and hand hygiene habits between attending and resident anesthesiologists were correlated with mobile phone colonization.

METHODS

A prevalence study was conducted over a 6-month period from 2017 to 2018 that involved the collection of samples from the mobile phones of the anesthesiology team and culturing for surveillance. A questionnaire was administered to assess the mobile phone sanitization and hand washing routines of the anesthesia team in specific situations.

RESULTS

Bacterial contamination was detected for 86 of the 128 mobile phones examined (67.2%). A greater presence of Micrococcus spp. on devices was correlated with a higher frequency of mobile phone use (p=0.003) and a lower frequency of sanitization (p=0.003). The presence of bacteria was increased on the mobile phones of professionals who did not perform handwashing after tracheal intubation (p=0.003).

CONCLUSION

Hand hygiene and device sanitization habits were more important than the use behavior, as a higher presence of bacteria correlated with poorer hygiene habits. Furthermore, handwashing is the best approach to prevent serious colonization of mobile devices and the possible transmission of pathogens to patients under the care of anesthesiologists.

Isolation and identification of microorganisms associated with automated teller machines on Federal Polytechnic Ede campus

Automated Teller Machines (ATM) are visited everyday by millions of people. This machine is accessible to the general public irrespective of class, age or race. The contact point of all ATM machines is the hand which on their own are ‘vaults’ of microorganisms. An elaborate survey was taken for complete assessment of possible microbial contamination in the Federal Polytechnic Ede campus. Selected ATM machines on campus were used as case study to characterize, identify and determine the degree of bacterial contamination of microorganisms and their potential as reservoir of microbes. Swabs were collected from each ATM screen, buttons, floor, user’s hand, and exposure of plates. After collection of the samples, they were plated in nutrient agar. The results showed the presence of increased bacterial count subsequently, most pathogens on characterization revealed the genus of the particular organisms E. coli, Pseudomonas, Staphylococcus aureus, Klebsiella, Micrococcus, Salmonella and Serratia. The study showed the potential hazard inherent in ATM machine usage and draws attention to our level of hand hygiene compliance.

A pilot metagenomic study reveals that community derived mobile phones are reservoirs of viable pathogenic microbes

There is increasing attention focussed on the risks associated with mobile phones possibly serving as ‘Trojan Horse’ fomites for microbial transmission in healthcare settings. However, little is reported on the presence of microbes on community derived mobile phones which in 2021, numbered in the billions in circulation with majority being used on a daily basis. Identify viable microbial organisms swabbed from smartphones on a university campus. Entire surfaces of 5 mobile phones were swabbed and examined for their microbial content using pre-agar-based growths followed by downstream DNA metagenomic next-generation sequencing analysis. All phones were contaminated with viable microbes. 173 bacteria, 8 fungi, 8 protists, 53 bacteriophages, 317 virulence factor genes and 41 distinct antibiotic resistant genes were identified. While this research represents a pilot study, the snapshot metagenomic analysis of samples collected from the surface of mobile phones has revealed the presence of a large population of viable microbes and an array of antimicrobial resistant factors. With billions of phones in circulation, these devices might be responsible for the rise of community acquired infections. These pilot results highlight the importance of public health authorities considering mobile phones as ‘Trojan Horse’ devices for microbial transmission and ensure appropriate decontamination campaigns are implemented.

Antimicrobial susceptibility of bacterial pathogens isolated from healthcare workers' cellphones

OBJECTIVE

To evaluate bacterial isolates, antibiotic susceptibility, and disease transmission risk in healthcare workers using cellphones.

METHODS

A total of 70 cellphones were received from the hospital staff. Samples were collected from the phones with a sterile cotton swab moistened with physiological saline solution. Samples were inoculated in a bacteriological culture medium and incubated at 37.5°C for 24-48hours. Identification of microorganisms was performed by traditional methods and VITEK 2 device. Kirby-Bauer disk diffusion method was used to determine antibiotic susceptibility.

RESULTS

A total of 26 species and 170 microorganisms were isolated from 66 cellphones from which bacterial growths were obtained: coagulase-negative staphylococci (n=63, 37%) (most commonly Staphylococcus epidermidis: 25/63), Micrococcus luteus (n=25, 14.7%), Tetracoccus (n=24, 14.1%), Kocuria spp. (n=24, 14.1%), Corynebacterium diphtheriae (n=7, 4.1%), Leuconostoc mesenteroides (n=5, 3.0%), S. aureus (n=4, 2.3%), Enterococcus spp. (n=5, 2.9%), Acinetobacter spp. (n=7, 4.1%), Klebsiella pneumoniae (n=2, 1.2%), Actinomyces spp. (n=1, 0.6%), Pseudomonas aeruginosa (n=1, 0.6%), Morganella morganii (n=1, 0.6%), and Alcaligenes faecalis (n=1, 0.6%). Gram-positive isolates were all susceptible to the antibiotics used, whereas Gram-negative isolates were all resistant to ceftazidime.

CONCLUSION

Hands and/or cellphones of healthcare staff can be contaminated with various types of microorganisms. We recommend proper hand washing and disinfection to prevent bacterial pathogens spread within the hospital.

Multidrug-Resistant Bacteria on the Mobile Phones and Computer Keyboards of Healthcare University Students in Ghana

Globally, mobile phones and computers (laptops and desktops) are indispensable part of human lives for communication, entertainment, and educational purposes. However, there are concerns about the increasing risk of bacterial contamination and antibiotic resistant trends from the surfaces of these devices. This study aims to assess bacterial contamination of mobile phones and computer keyboards and their resistant profile at the University of Ghana, Korle-Bu Campus, Accra. This was a cross-sectional study conducted from March to June 2017 with 240 swabs collected from the surfaces of mobile phones and computer keyboards used by healthcare students. Swabs were cultured on MacConkey, blood, and mannitol salt agar. Bacteria identification was performed with a standard bacteriological method. A total of 91 bacterial isolates were obtained from the devices, and they were tested against 9 commonly used antibiotics by the Kirby-Bauer disc method. The study revealed mobile phones and computer keyboards had contamination levels of 83.3% and 43.3%. Bacteria isolated included Staphylococcus epidermidis (25.4%), Klebsiella spp. (12.9%), Staphylococcus aureus (9.2%), Escherichia coli (6.7%), Pseudomonas spp. (5.4%), Enterobacter cloacae (2.1%), and Enterobacter spp. (1.7%). Overall, 91 bacterial isolates were highly resistant to ampicillin (96.7%) and tetracycline (75.8%) and moderately resistant to chloramphenicol (49.5%) with lower resistance to cefotaxime (18.7%), ceftadizime (14.2%), ciprofloxacin (25.3%), and gentamycin (24.7%). Additionally, 45.1% of isolates were multidrug resistant. Findings from this study revealed mobile phones and computer keyboards of healthcare students in the university were contaminated with pathogenic bacteria. Hence, frequent hand hygiene and disinfection of mobile phones and computer keyboard surfaces is encouraged to minimize the spread of resistant bacteria pathogens.

Disinfecting handheld electronic devices with UV-C in a healthcare setting

Handheld Electronic Devices (HEDs) play a central role in the hospital environment. However, they can be a vehicle for transmitting (pathogenic) microorganisms. We studied whether disinfection with UV-C light is successful in disinfecting three different HEDs in a clinical setting. Disinfection with UV-C light was performed with the UV-Smart® D25. We took a total of 800 samples on two departments and counted colony forming units. More than half of the baseline measurements were moderately (>10CFU) or highly (>50 CFU) contaminated. Post-disinfection the CFU was 0 in 87% of measurements. We conclude that the UV-Smart® D25 can be used to disinfect non-critical HEDs in clinical healthcare.

A metagenomic-based method to study hospital air dust resistome

As a symbol of the defense mechanisms that bacteria have evolved over time, the genes that make bacteria resist antibiotics are overwhelmingly present in the environment. Currently, bacterial antibiotic resistance genes (ARGs) in the air are a serious concern. Previous studies have identified bacterial communities and summarized putative routes of transmissions for some dominant hospital-associated pathogens from hospital indoor samples. However, little is known about the possible indoor air ARG transportation. In this study, we mainly surveyed air-conditioner air dust samples under different airflow conditions and analyzed these samples using a metagenomic-based method. The results show air dust samples exhibited a complex resistome, and the average concentration is 0.00042 copies/16S rRNA gene, which is comparable to some other environments. The hospital air-conditioners can form resistome over time and accumulate pathogens. In addition, our results indicate that the Outpatient hall is one of the main ARG transmission sources, which can distribute ARGs to other departments (explains >80% resistome). We believe that the management should focus on ARG carrier genera such as Staphylococcus, Micrococcus, Streptococcus, and Enterococcus in this hospital and our novel evidence-based network strategy proves that plasmid-mediated ARG transfer can occur frequently. Overall, these results provide insights into the characteristics of air dust resistome and possible route for how ARGs are spread in air.

Bacterial contamination of mobile phones of healthcare workers at the University Teaching Hospital, Lusaka, Zambia

Background

Mobile telephones (henceforth 'phones') have become an essential part of everyday life in both healthcare and community settings. However, the widespread use of mobile phones in healthcare facilities is of concern because they can act as vehicles for transmitting pathogenic bacteria. This study aimed to investigate the bacterial contamination of mobile phones of healthcare workers (HCWs) at the University Teaching Hospital, Lusaka, Zambia.

Methods

This cross-sectional study, from May to July 2019, involved 117 HCWs. A self-administered questionnaire was used to gather sociodemographic and phone usage data. The mobile phones of HCWs were swabbed for culture and antimicrobial susceptibility testing.

Results

The overall prevalence of mobile phone contamination was 79%. The predominant isolates were coagulase-negative staphylococci (50%), Staphylococcus aureus (24.5%) and Bacillus spp. (14.3%). Other isolates were Escherichia coli, Acinetobacter spp., Pseudomonas spp., Klebsiella sp. and Proteus sp. Most isolates were susceptible to tetracycline, gentamicin and cotrimoxazole, while all Gram-positive organisms were resistant to penicillin. Meticillin resistance was detected in 25% and 48% of S. aureus and coagulase-negative staphylococci isolates, respectively. No significant association was found between mobile phone contamination and age group, gender, profession, mobile phone disinfection or work area.

Conclusion

Mobile phones of HCWs carry potentially pathogenic bacteria and can be a source of healthcare-associated infections in healthcare settings. Hence, regulations regarding the use of mobile phones need to be developed, especially in critical areas, to reduce the dissemination of pathogenic bacteria from hands to phones and, potentially, to patients.

Hidden reservoirs of pathogens in dental settings

Nosocomial infections are a major concern to both clinicians and health care seekers. Investigations have suggested that laptops & mobile phones may contribute to cross-contamination and can serve as vehicles for infection transmission. Therefore, it is of interest to document the data on hidden reservoirs such as mobile phones and laptops of pathogens in dental settings at the Hazaribag College of dental sciences and Hospital, Jharkhand. The samples were collected from 25 laptops and 25 mobile phones from dentists working in a dental college in Hazaribag city. The samples were collected aseptically using sterile cotton swabs dipped in sterile saline by rotating the swabs on the keyboard surfaces of laptops and mobile phones, inoculated into Brain Heart Infusion broth, vortexed for 1 minute in Fischer Vortex Genie 2 on highest setting & streaked immediately on 5% sheep blood agar plates and were incubated at 37°C for 24 hours aerobically. The isolates were identified based on the colony morphology, colony characteristics and biochemical reactions. The bacterial species isolated were Staphylococcus aureus, Coagulase negative Staphylococcus, Bacillus species, Enterococci, Micrococci, and Pseudomonas etc. Predominant species isolated was Staphylococcus aureus and least was Micrococci. Higher percentage of organisms was found at the Department of Periodontics, Endodontics and least was found in Department of Public Health Dentistry. The percentage and type of organism isolated from keyboards of laptops and mobile phones were similar. Thus, laptops and mobile phones act as vehicles for transfer of potential pathogens associated with dental hospitals. Disinfecting the hands prior to examination of patients and disinfection of laptops and mobiles with alcohol wipes should be done to prevent nosocomial infections.

Future Mobile Device Usage, Requirements, and Expectations of Physicians in German University Hospitals: Web-Based Survey

Background

The use of mobile devices in hospital care constantly increases. However, smartphones and tablets have not yet widely become official working equipment in medical care. Meanwhile, the parallel use of private and official devices in hospitals is common. Medical staff use smartphones and tablets in a growing number of ways. This mixture of devices and how they can be used is a challenge to persons in charge of defining strategies and rules for the usage of mobile devices in hospital care.

Objective

Therefore, we aimed to examine the status quo of physicians’ mobile device usage and concrete requirements and their future expectations of how mobile devices can be used.

Methods

We performed a web-based survey among physicians in 8 German university hospitals from June to October 2019. The online survey was forwarded by hospital management personnel to physicians from all departments involved in patient care at the local sites.

Results

A total of 303 physicians from almost all medical fields and work experience levels completed the web-based survey. The majority regarded a tablet (211/303, 69.6%) and a smartphone (177/303, 58.4%) as the ideal devices for their operational area. In practice, physicians are still predominantly using desktop computers during their worktime (mean percentage of worktime spent on a desktop computer: 56.8%; smartphone: 12.8%; tablet: 3.6%). Today, physicians use mobile devices for basic tasks such as oral (171/303, 56.4%) and written (118/303, 38.9%) communication and to look up dosages, diagnoses, and guidelines (194/303, 64.0%). Respondents are also willing to use mobile devices for more advanced applications such as an early warning system (224/303, 73.9%) and mobile electronic health records (211/303, 69.6%). We found a significant association between the technical affinity and the preference of device in medical care (χs2=53.84, P<.001) showing that with increasing self-reported technical affinity, the preference for smartphones and tablets increases compared to desktop computers.

Conclusions

Physicians in German university hospitals have a high technical affinity and positive attitude toward the widespread implementation of mobile devices in clinical care. They are willing to use official mobile devices in clinical practice for basic and advanced mobile health uses. Thus, the reason for the low usage is not a lack of willingness of the potential users. Challenges that hinder the wider adoption of mobile devices might be regulatory, financial and organizational issues, and missing interoperability standards of clinical information systems, but also a shortage of areas of application in which workflows are adapted for (small) mobile devices.

Shining a light on the pathogenicity of health care providers' mobile phones: Use of a novel ultraviolet-C wave disinfection device

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Novel UV-C device found to significantly decrease total and pathogenic bacteria on mobile phones.

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UV-C phone disinfecting device is renewable, efficient and effective..

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UV-C device implementation in a hospital system would be desired by healthcare providers.

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Healthcare providers felt their mobile phones were an important risk factor in infection transmission and that they would use this device daily to weekly.

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UV-C technology is shown to kill coronaviruses and implementation of this device could be impactful during pandemic.

Background

Mobile phones are known to carry pathogenic bacteria and viruses on their surfaces, posing a risk to healthcare providers (HCPs) and hospital infection prevention efforts. We utilize an Ultraviolet-C (UV-C) device to provide an effective method for mobile phone disinfection and survey HCPs about infection risk.

Methods

Environmental swabs were used to culture HCPs’ personal mobile phone surfaces. Four cultures were obtained per phone: before and after the UV-C device's 30-second disinfecting cycle, at the beginning and end of a 12-hour shift. Surveys were administered to participants pre- and poststudy.

Results

Total bacterial colony forming units were reduced by 90.5% (P = .006) after one UV-C disinfection cycle, and by 99.9% (P = .004) after 2 cycles. Total pathogenic bacterial colony forming units were decreased by 98.2% (P = .038) after one and >99.99% (P = .037) after 2 disinfection cycles. All survey respondents were willing to use the UV-C device daily to weekly, finding it convenient and beneficial.

Discussion

This novel UV-C disinfecting device is effective in reducing pathogenic bacteria on mobile phones. HCPs would frequently use a phone disinfecting device to reduce infection risk.

Conclusions

In light of the ongoing coronavirus (COVID-19) pandemic, a standardized approach to phone disinfection may be valuable in preventing healthcare-associated infections.

Microbial Incidence and Antibiotic susceptibility for Bacterial isolates in The Mobile Phone of Healthcare workers and University Employments in Basrah City

The mobile phones come to be an important device all people use it for communication and phones can be contaminated with bacterial isolates. this study tries to do a little investigation about kinds and percent of pathogenic bacteria and the detection of some antibiotic resistance one and difference between that found in the healthcare worker’s mobile phone and peoples who work out of that field. Samples collection were done using mobile phones belongs to healthcare workers and Basra University employments. Swabs were cultured on different media then the suspected colonies were identified by recognizing the morphology of colonies, staining with Gram’s stain then tested with biochemical tests. Our study shows bacterial isolates in all the screened mobile phone, The highest proportions were recorded by Bacillus spp (66%) and Pseudomonas spp (56%) while the lowest proportions were Staphylococcus aureus (8%) and Candida spp (12%). And there was a significant difference in the kinds and percent of bacterial isolates between the healthcare workers and employments mobile phones, besides the appearance of Cefotaxime and Cefatizoxime resistance Proteus sp. and Trimethoprim + Sulfamethoxazole resistance Klebsiella spp. also the intermediate susceptibility to the different antibiotic was shown in all isolates. All the mobile phones can be contaminated by various kinds of bacteria some of these were resistant to some antibiotics and there was a significant difference in the percent and kinds of bacterial isolates between the health care worker and people who work out of this field.

Elucidation of Practices of Mobile Phone Hygiene and Identification of the Microorganisms: A Perspective Study from Riyadh, Saudi Arabia

Mobile phones (MPs) have become a tool for the transmission of microorganisms due to lack of personal hygiene and maybe the sharing of the mobile phone by more than one person that which leads it to be a suitable carrier for microbes. This study aimed to draw a bead on the practices of hygiene of MPs among people living in Riyadh, Saudi Arabia, by performing a cross-sectional survey of 204 participants. The response rate of this study was above ~95%. Results showed that 19.6 % of responders clean their MPs once in a day, but the majority (33.8%) never cleaned their MPs. More than a quarter of the respondents (28.4%) use tissue paper to clean MPs. Among the users, ~60% use MPs while eating, 76% realized that their MPs might be resource of transmitting microorganisms. The study was also carried out using standard techniques to identify and count the bacterial contamination using the MPs. A combined number of 75 MPs of the participants in the shopping malls of Riyadh were screened for microorganism identification. From 75 public MPs, 109 bacteria were isolated. Coagulase-negative staphylococci were the predominant organisms isolate (76.1%) and with 1.8% by Staphylococcus aureus. Micrococcus sps. was also found (12.8%). A small number of Kocuria sps. were also isolated (4.6%). These results showed that common peoples’ mobile phones were contaminated with various types of microorganisms. The results provide an evidence base for the development and enhancement of hygienic MPs using practices.

Mobile Phones: A Possible Vehicle of Bacterial Transmission in a Higher Learning Institution in Malaysia

Background

Mobile phones (MPs) have become one of the most indispensable accessories in social and professional life. Though they offer plenty of benefits, MPs are prolific breeding grounds for infectious pathogens in communities. Thus, the aim of this study was to identify the prevalence of bacterial contamination and determine antimicrobial susceptibility pattern of Staphylococcus aureus (S. aureus) from MPs.

Methods

A cross-sectional study was conducted from March to July 2019 on 126 students and 37 laboratory staff/clinical instructors' MPs from the Faculty of Health Sciences, Universiti Teknologi MARA, Malaysia by a simple random sampling technique. Along with the questionnaire, a swab sample from each participant's MPs was collected and transported to the microbiology laboratory for bacterial culture as per standard microbiological procedures and antimicrobial susceptibility test by the disc diffusion technique. Data were analysed by the Statistical Package for Social Sciences Programme version 24.

Results

All of the tested MPs were contaminated with either single or mix bacterial agents. Bacillus spp. (74.8%), coagulase-negative staphylococci (CoNS; 47.9%) and S. aureus (20.9%) were the most predominant bacterial isolates, whilst the least isolate was Proteus vulgaris (P. vulgaris) (2.5%). Oxacillin resistance was seen in 5.9% of S. aureus isolate. A comparison of bacteria type and frequency among gender showed a significant difference with P. vulgaris (P = 0.003) and among profession showed a significant difference with S. aureus (P = 0.004).

Conclusion

The present study indicates that MPs can serve as a vector for both pathogenic and non-pathogenic organisms. Therefore, full guidelines about restricting the use of MPs in laboratory environments, hand hygiene and frequent decontamination of MPs are recommended to limit the risk of cross-contamination and healthcare-associated infections caused by MPs.

A review on mobile phones as bacterial reservoirs in healthcare environments and potential device decontamination approaches

Mobile communication devices (MCDs), including cell phones and smart phones, have become an essential part of everyday life. Despite their frequent usage, most people, even healthcare personnel, often ignore the possibility that these devices might accumulate to carry a variety of microbial flora during and after the inspection of patients. The handling of MCDs with unwashed hands and/or their seldom cleaning can aggravate potential health risks. Many of the harbored bacteria species can be harmful to immune-suppressed patients for whom the disinfection precautions should be taken more seriously. In this review, we discuss the significance of maintaining the cleanliness of mobile devices, especially in healthcare settings, to prevent the spread of nosocomial infections in patients. Furthermore, we discuss strategies to address microbial contamination of MCDs to maintain good hand hygiene for the users of smartphones or other mobile communication devices. These techniques are capable of providing instant disinfection of the devices along with residual effects over prolonged periods.

Phenotypic and Genotypic Characterization with MALDI-TOF-MS Based Identification of Staphylococcus spp. Isolated from Mobile Phones with their Antibiotic Susceptibility, Biofilm Formation, and Adhesion Properties

Cell phones, smartphones, and tablets are extensively used in social and professional life, so they are frequently exposed to bacteria. The main goal of the present work was to isolate and characterize Staphylococci strains from students’ cell phone mobiles. Subsequently, 24 Staphylococci strains were tested against a wide range of antibiotics, for the distribution of some virulence-related genes and their ability to form biofilm. Staphylococcus spp. were cultured from all studied devices on chromogenic medium and identified using the matrix-assisted laser desorption/ionization (MALDI), time-of-flight (TOF) mass spectrometry (MS) technique (MALDI-TOF-MS). The results obtained showed that S. aureus was the dominant species (19 strains, 79.1%), followed by S. warneri (3 strains, 12.5%), and S. haemolyticus (2 strains, 8.3%). Isolated strains showed high percentages of hydrolytic enzymes production, resistance to many tested antibiotics, and 37.5% expressed the mecA gene. The tested strains were highly adhesive to polystyrene and glass and expressed implicated icaA (62.5%) and icaD (66.6%) genes. All Staphylococcus spp. strains tested were found to possess proteases and the α-hemolysin gene. Our results highlighted the importance of mobile phones as a great source of Staphylococcus spp., and these species were found to be resistant to many antibiotics with multiple antibiotic resistance (MAR) index ranging from (0.444) to (0.812). Most of the studied strains are able to form biofilm and expressed many virulence genes. Phylogenetic analysis based on the phenotypic and genetic characters highlighted the phenotypic and genetic heterogeneity of the S. aureus population studied. Further analyses are needed to elucidate the human health risks associated with the identified Staphylococci strains.

Contaminación bacteriológica en teléfonos celulares de trabajadores de la salud en ambiente clínico: revisión sistemática

Se realizó una revisión sistemática para identificar microorganismos reportados como agentes contaminantes en teléfonos celulares de trabajadores de la salud, que realizan actividades en ambientes clínicos. Se incluyeron publicaciones entre 2008 y 2018, mediante búsqueda en seis bases de datos usando palabras clave como “nosocomial pathogen” "healthcare workers" y "cell phone", entre otros. Dos investigadores de forma independiente realizaron la búsqueda y revisión de artículos. La calidad de los mismos se evaluó mediante lista de chequeo STROBE. Veintiún artículos fueron analizados. En todos los estudios se identificó presencia de contaminación en los celulares de los trabajadores de la salud, con una mediana de 84,3%, resaltando la presencia de Staphylococcus aureus (85,7%) y Escherichia coli (61,9%). Se concluye que el uso de los teléfonos celulares en ambiente hospitalario por parte de los trabajadores de la salud se constituye en una fuente potencial de trasmisión de microorganismos de interés clínico.

Mobile phones represent a pathway for microbial transmission: A scoping review

BACKGROUND

Mobile phones have become an integral part of modern society. As possible breeding grounds for microbial organisms, these constitute a potential global public health risk for microbial transmission.

OBJECTIVE

Scoping review of literature examining microbial's presence on mobile phones in both health care (HC) and community settings.

METHODS

A search (PubMed&GoogleScholar) was conducted from January 2005-December 2019 to identify English language studies. Studies were included if samples from mobile phones were tested for bacteria, fungi, and/or viruses; and if the sampling was carried out in any HC setting, and/or within the general community. Any other studies exploring mobile phones that did not identify specific microorganisms were excluded.

RESULTS

A total of 56 studies were included (from 24 countries). Most studies identified the presence of bacteria (54/56), while 16 studies reported the presence of fungi. One study focused solely on RNA viruses. Staphylococcus aureus, and Coagulase-Negative Staphylococci were the most numerous identified organisms present on mobile phones. These two species and Escherichia coli were present in over a third of studies both in HC and community samples. Methicillin-resistant S. aureus, Acinetobacter sp., and Bacillus sp. were present in over a third of the studies in HC settings.

CONCLUSIONS

While this scoping review of literature regarding microbial identification on mobile phones in HC and community settings did not directly address the issue of SARS-CoV-2 responsible for COVID-19, this work exposes the possible role of mobile phones as a 'Trojan horse' contributing to the transmission of microbial infections in epidemics and pandemics.

Dangerous passengers: multidrug-resistant bacteria on hands and mobile phones

INTRODUCTION

It is recognized that mobile phones may play a role in microorganism transmission and that hand hygiene, is considered the most important action for preventing infections and the spread of pathogens. The objective of this study was to determine presence and circulation bacteria on hands and mobile phones capable of causing infections in people and also determine if disinfection with gel-alcohol is useful to reduce the bacterial colonization.

METHODS

The bacterial evaluation included 596 hands of participants and 256 mobile phones. Isolated colonies were identified by biochemical test and confirmed by gene 16S rRNA sequencing. Antimicrobial susceptibility was performed using the automated instrument Vitek®2-Compact and disk-diffusionmethod.

RESULTS

In total, 92.9% of mobile phones and 98.3% of participants in study demonstrated evidence of bacterial contamination with different types of bacteria. Surprisingly, we observed that 18.6% plaques inoculated with disinfected fingers showed bacterial growth. In general, Gram negative isolates showed resistance to a higher number of antibiotics tested than Gram positive isolates.

CONCLUSIONS

Our results could help to raise awareness in our society about the importance of hand hygiene, as well as frequently used devices, reducing bacterial contamination and limiting the possibility of transmission of resistant multi-drug bacteria.

Pathogenic microbes contaminating mobile phones in hospital environment in Northeast India: incidence and antibiotic resistance

BACKGROUND

The present study attempts to identify and determine the pattern of drug susceptibility of the microorganisms present in mobile phones of health care workers (HCWs) and non-HCWs in a hospital environment. Mobile phones of 100 participants including both genders were randomly swabbed from nine different wards/units and the bacterial cultures were characterized using VITEK 2 system.

RESULTS

Forty-seven mobile phones were culture positive and a total of 57 isolates were obtained which consisted of 28 Gram-positive organisms and 29 Gram-negative organisms. The predominating organisms were Acinetobacter baumannii and Staphylococcus hominis. Among all the isolates from the mobile phones of HCW and non-HCWs, five isolates had ESBL and three isolates had colistin resistance. Incidentally, MRSA was not found on the mobile phones tested. The isolated organisms showed 100% susceptibility to linezolid, daptomycin, vancomycin, imipenem, meropenem, gentamicin, amikacin, ciprofloxacin and tigecycline, while high resistance was shown against benzylpenicillin (75.0%), cefuroxime and cefuroxime axetil (56.5%). Non-HCWs' mobile phones were more contaminated as compared to HCWs (P = 0.001) and irrespective of individuals' gender or toilet habits, both Gram-positive and Gram-negative organisms were present on the mobile phones.

CONCLUSION

This study reports for the first time that the mobile phones of non-health care workers harbour more bacterial diversity and are more prone to cause transmission of pathogens. This study can serve to educate the public on personal hand hygiene practices and on maintaining clean mobile phones through antiseptic measures.

Assessment of surface cleaning and disinfection in neonatal intensive care unit

Background

Surveillance for healthcare-associated infections (HAI) is a priority in the neonatal intensive care unit (NICU), given the critical immune status of patients. The aim of this study was to assess surface bacterial contamination before and after improving cleaning and disinfection practices.

Materials and methods

This was a cross-sectional study conducted in March 2018. Surface samples were taken from the same areas in three steps: after cleaning, after "improved" cleaning, and after terminal disinfection using hydrogen peroxide vapor (VHP). Sampling and culture was carried out according to standard ISO14698-1: 2004. Results interpretation was based on the thresholds defined by good hospital pharmacy practice. Statistical analysis was performed by SPSS 21.0 and a P-value < 0.05 was considered to be significant.

Results

In total, 290 samples were taken from different zones: fixed equipment (69%), aseptic washbasins (12%), pneumatic system (9%), computer equipment (6%) and mobile equipment (4%). Prevalence of non-compliances after cleaning and disinfection was 75%, 10% after “improved” cleaning, and 0% after automated VHP (P < 0.0001). Median of CFU was 24[EI (0–625)] after standard cleaning, 2[EI (0–35)] after “improved” cleaning and 0 [EI (0–3)] after VHP (P < 0.0001). Isolated germs werecoagulase-negative Staphylococcus (31.2%), Acinetobacter baumannii (26%), Staphylococcus aureus (19.5%), Pseudomonas aeruginosa (9%), Klebsiella pneumoniae (9%), E. coli (4%) and Enterobacter sp (1.3%).

Conclusion

Improved cleaning and disinfection practices associated to VHP give microbiological satisfactory results. It is important to educate cleaning staff for effective surface cleaning and disinfection operations to control HAI.

Prevalence of Multidrug-Resistant Bacteria on Mobile Phone Surface

Background:

With the introduction of multiple uses of mobile phones, including social networking sites, people are being addicted to the device. Most people carry the device to places which are loaded with possible pathogenic microorganisms such as toilets and washrooms, enabling the device to act as a potent fomite.

Aims and Objective:

This study aims to determine the presence of potential pathogenic and multidrug-resistant (MDR) bacteria on the surface of mobile phones used by different occupational groups. It also aims to identify a possible relationship between mobile phone usage in toilets and mobile phone usage while eating.

Materials and Methods:

Two hundred and sixty-eight interviewees belonging to four different occupational groups; 204 students, 24 security staffs, 21 food vendors, and 19 cleaning staff participated in the study in a university, of which 67.54% (n = 181/268) admitted to carry their mobile phones into toilets and 60.07% (n = 161/268) of the total respondents stated that they used their mobile phones while being confined in toilets.

Results:

MDR bacterial presence were observed for both case (90.54%, n = 67/74) and control (73.07%, n = 19/26) study of the 100 swabbed samples and the association between usage of the mobile phone while being confined in toilets and while eating by the same respondent were statistically significant (P = 0.00 ≤ 0.05).

Conclusion:

The study signifies that mobile phones are carriers of pathogenic and MDR bacteria. Therefore, cleanliness and hygiene issues should be prioritized with an awareness to minimize or restrict the use of mobile phones in unfavorable and unhygienic environments such as toilets and washrooms.

Evaluation of the Cell Phone Microbial Contamination in Dental and Engineering Schools: Effect of Antibacterial Spray

INTRODUCTION

The aim of this study was to evaluate the microbial contamination of cell phone in dental and engineering schools and also investigating the effect of an antibacterial spray.

METHOD AND MATERIALS

A questionnaire was completed by participants, including the pattern of using mobile phones and their disinfection. The number of participants was 120 students and professors in each of dental and engineering schools. Swabs from mobile phones of the participants were taken and plated on culture medium. The t-test, Chi-Square with the SPSS 11.5 program were used in data analysis.

RESULTS

In total, 240 mobile phones were cultured for microorganisms, while 65.8% (n = 158) were culture-positive. One hundred percent of professors, 98% of students' dental school and 72% of professors and 62% of students of engineering, believe that mobile can serve as a source of pathogens.

The most commonly cultured organisms were Staphylococcus Aureus, Escherichia coli, Enterococcus Faecalis, and Pseudomonas. The current study showed that none of the mobile phones of the professors and students of the engineering university was infected by Pseudomonas and Candida albicans.

CONCLUSION

The results of this study showed that mobile phones may act as an important source of nosocomial pathogens.

How often are health care personnel hands colonized with multidrug- resistant organisms? A systematic review and meta-analysis

BACKGROUND

Hands of health care personnel (HCP) can transmit multidrug-resistant organisms (MDROs), resulting in infections. Our aim was to determine MDRO prevalence on HCP hands in adult acute care and nursing facility settings.

METHODS

A systematic search of PubMed/MEDLINE, Web of Science, CINAHL, Embase, and Cochrane CENTRAL was performed. Studies were included if they reported microbiologic culture results following HCP hands sampling; included prevalent MDROs, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, Clostridium difficile, Acinetobacter baumannii, or Pseudomonas aeruginosa, and were conducted in acute care or nursing facility settings.

RESULTS

Fifty-nine articles comprising 6,840 hand cultures were included. Pooled prevalence for MRSA, P aeruginosa, A baumannii, and vancomycin-resistant Enterococcus were 4.26%, 4.59%, 6.18%, and 9.03%, respectively. Substantial heterogeneity in rates of pathogen isolation were observed across studies (I² = 81%-95%). Only 4 of 59 studies sampled for C difficile, with 2 of 4 finding no growth. Subgroup analysis of MRSA revealed the highest HCP hand contamination rates in North America (8.28%). Sample collection methods used were comparable for MRSA isolation (4%-7%) except for agar direct contact (1.55%).

CONCLUSIONS

Prevalence of common MDROs on HCP hands vary by pathogen, care setting, culture acquisition method, study design, and geography. When obtained at an institutional level, these prevalence data can be utilized to enhance knowledge, practice, and research to prevent health care-associated infections.

Cell phone etiquette in the clinical arena: A professionalism imperative for healthcare

Cell phones have become a routine part of daily life in the United States; 97.1% of faculty, residents, and medical students carry their personal cell phone with them at work. Concerns about professionalism and potentially inappropriate use of mobile technology have emerged, and challenges to professionalism that are associated with the use of mobile devices in the clinical setting are evolving as technology advances. These issues should be directly addressed by the medical profession. Concerns include questions of privacy/confidentiality, microbial transmission from contact with mobile devices, maintenance of personal/professional boundaries when physicians and patients use mobile devices to communicate, appropriate communication among colleagues, and prioritization of patient care over personal matters.

SELfies and CELLfies: Whole Genome Sequencing and Annotation of Five Antibiotic Resistant Bacteria Isolated from the Surfaces of Smartphones, An Inquiry Based Laboratory Exercise in a Genomics Undergraduate Course at the Rochester Institute of Technology

Are touchscreen devices a public health risk for the transmission of pathogenic bacteria, especially those that are resistant to antibiotics? To investigate this, we embarked on a project aimed at isolating and identifying bacteria that are resistant to antibiotics from the screens of smartphones. Touchscreen devices have become ubiquitous in society, and it is important to evaluate the potential risks they pose towards public health, especially as it pertains to the harboring and transmission of pathogenic bacteria that are resistant to antibiotics. Sixteen bacteria were initially isolated of which five were unique (four Staphylococcus species and one Micrococcus species). The genomes of the five unique isolates were subsequently sequenced and annotated. The genomes were analyzed using in silico tools to predict the synthesis of antibiotics and secondary metabolites using the antibiotics and Secondary Metabolite Analysis SHell (antiSMASH) tool in addition to the presence of gene clusters that denote resistance to antibiotics using the Resistance Gene Identifier (RGI) tool. In vivo analysis was also done to assess resistance/susceptibility to four antibiotics that are commonly used in a research laboratory setting. The data presented in this manuscript is the result of a semester-long inquiry based laboratory exercise in the genomics course (BIOL340) in the Thomas H. Gosnell School of Life Sciences/College of Science at the Rochester Institute of Technology.

Bacterial colonization of healthcare workers' mobile phones in the ICU and effectiveness of sanitization

Extra-European studies report high rates of multi-drug resistant bacteria colonization of healthcare workers' mobile phones in intensive care units. We aimed to assess the prevalence of bacterial colonization of healthcare workers' mobile phones in an intensive care unit in France and the effectiveness of a sanitization product. We designed a prospective, monocentric study in a 15-bed intensive care unit within a 300-bed private hospital. Bacterial colonization was assessed on 56 healthcare workers' mobile phones immediately before and 5 min after sanitization of the phones with bactericidal wipes. The mobile phones of 42 administrative staff acted as controls. All mobile phones in both groups were colonized. Healthcare workers' phones had a higher number of different bacterial species per phone (2.45 ± 1.34 vs. 1.81 ± 0.74, p = 0.02). Colonization with pathogens did not differ significantly between healthcare workers' and controls' phones (39.3% vs. 28.6%, p = 0.37). Excluding coagulase negative Staphylococcus, Staphylococcus aureus was the most common pathogen found in both groups (19.6% and 11.9%, p = 0.41). Only one healthcare workers' mobile phone was colonized by methicillin-resistant Staphylococcus aureus, and no other multi-drug resistant bacteria was detected. No covariate was associated with pathogen colonization. After sanitization, 8.9% of mobile phones were sterilized, and colonization with pathogenic bacteria decreased (21.4% vs. 39.3%, p = 0.04) as did the number of CFUs/mL (367 ± 404 vs. 733 ± 356, p < 0.001). Colonization of intensive care unit healthcare workers' and administrative staff's mobile phones was similar. Colonization with pathogens was frequent but colonization with multi-drug resistant bacteria was rare. Disinfecting the phones with bactericidal wipes is not completely effective. Specific sanitization protocols and recommendations regarding the management of healthcare workers' mobile phones in intensive care units should be developed. Additionally, good hand hygiene after touching mobile phones should be kept in mind to prevent cross-infections.

Development process and patient usability preferences for a touch screen tablet-based questionnaire

We sought to design a touch tablet asthma questionnaire while identifying patient preferences for usability features of such questionnaires. We created an evidence-based prototype and employed rapid-cycle design (semi-structured focus group testing, analysis, corresponding modifications, re-testing) with asthma patients aged ⩾16 years. We analyzed transcripts using deductive and inductive content analysis. Quantitative measures included Likert-type-scale responses, the System Usability Scale, and questionnaire completion times. There were 20 participants across five focus groups (15/20 female, age 49.1 ± 15.6 years). Usability-related themes included (1) "Touch Technology" (hygiene, touch technology familiarity, ease of use) and (2) "Questionnaire Design" (visual characteristics, navigation). Completion time was 11.7 ± 5.9 min. Summative Likert-type scale responses suggested high system usability, as did a System Usability Scale score of 84.2 ± 14.7. In summary, Attention to specific technology- and design-related preferences can result in a highly usable patient-facing touch tablet questionnaire. Our findings can inform touch questionnaire design across other diseases.

Surface touch and its network growth in a graduate student office

Fomites transmit infection. A key question is how surface contamination in a building is spread by human touch. Using video cameras, we collected more than 120 000 touch actions from 60 hours of high-resolution data on surface touch across five typical weekdays in a graduate student office. The students touched surfaces with one or both hands during 94.6% of the observed period. On average, each student made five touches per minute, with an average duration of 22 seconds per touch. High-touch and high-risk surfaces and people were identified. 98.8% of the surfaces touched, such as mobile phones and human faces, were private, but public surfaces, such as a water dispenser button, were touched by 68% of the students in the office on average. Compared with females, males spent 3% more time touching surfaces. Right hands always had higher touch frequency than left hands. The surface network in the office was scale-free, whereas the hand network was small-world. The results revealed power law and logistic growth in the number of contaminated surfaces which suggests that fomite transmission can be extremely effective. The time taken for most surfaces to be contaminated after one surface became contaminated was much shorter for public than for private surfaces.

Degree of Bacterial Contamination of Mobile Phone and Computer Keyboard Surfaces and Efficacy of Disinfection with Chlorhexidine Digluconate and Triclosan to Its Reduction

The main aim of our study was to verify the effectiveness of simple disinfection using wet wipes for reduction of microbial contamination of mobile phones and computer keyboards. Bacteriological swabs were taken before and after disinfection with disinfectant wipes with active ingredients chlorhexidine digluconate and triclosan. The incidence and type of microorganisms isolated before and after disinfection was evaluated; the difference was expressed as percentage of contamination reduction. Our results confirmed the high degree of surface contamination with bacteria, some of which are opportunistic pathogens for humans. Before the process of disinfection, on both surfaces, mobile phones, and computer keyboards, the common skin commensal bacteria like coagulase-negative staphylococci were diagnosed most frequently. On the keyboards, species of the genus Bacillus and representatives of the family Enterobacteriaceae were abundant. The potentially pathogenic species were represented by Staphylococcus aureus. Cultivation of swabs performed 5 min after disinfection and subsequent calculation of the reduction of contamination have shown that simple wiping with antibacterial wet wipe led to a significant reduction of microbial contamination of surfaces, with effect ranging from 36.8 to 100%.

Microbial contamination data of keypad and touch screen of cell phones among hospital and non-hospital staffs - A case study: Iran

Microorganisms live almost everywhere, they are even present on inanimate objects such as Mobile phones, as a result contaminates our body. The main purpose of this study was tantamount to compare microbial contamination of keypad and touch screen mobile cell phones between hospital and non-hospital staffs. Samples were collected from 456 cell phones of hospital and non-hospital. Microbial swab samples were taken from 1 cm² of surface from each cell phone, and incubated on Brain Heart Infusion agar media at 37.5 °C for 24 h. Isolated microorganisms were grown aerobically on 55% defibrinated Sheep Blood and eosin methylene blue agar media at 37.5 °C for 48 h. In present study the antibiotic microorganism-resistant could not be observed. Overall, 456 cell phones were collected: 240 (52.63%) from hospital staff (nurses), 216 (47.36%) from non-hospital staff (health care worker outside the hospital). The result indicates that the bacterial contamination of phones used by all of different investigated groups was lower in touch screen devices than keypad devices and the contamination was found more in hospital staff cellphone than non-hospital staff׳s cell device. Woman׳s cell also has a few colonies rather than man׳s cell phones. The dominant microorganisms in the hospital staff were, Enterobacteriaceae, Bacillus species, especially Gram-positive bacteria sporulated and staphylococcal negative coagulase, respectively. Cell phones could be a serious threat to the spread of cross-infection in hospitals, therefore development of hand hygiene and cell phone cleaning guidelines is needed regarding public cell phone use.

Cultivable Microbial Diversity Associated With Cellular Phones

A substantial majority of global population owns cellular phones independently to demographic factors like age, economic status, and educational attainment. In this study, we investigated the diversity of microorganisms associated with cellular phones of 27 individuals using cultivation-based methods. Cellular phones were sampled using cotton swabs and a total of 554 isolates representing different morphotypes were obtained on four growth media. Matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry could generate protein profiles for 527 isolates and species-level identification was obtained for 415 isolates. A dendrogram was constructed based on the protein profiles of the remaining isolates, to group 112 isolates under 39 different proteotypes. The representative strains of each group were selected for 16S rRNA gene and ITS region sequencing based identification. Staphylococcus, Bacillus, Micrococcus, and Pseudomonas were the most frequently encountered bacteria, and Candida, Aspergillus, Aureobasidium, and Cryptococcus were in case of fungi. At species-level the prevalence of Micrococcus luteus, Staphylococcus hominis, Staphylococcus epidermidis, Staphylococcus arlettae, Bacillus subtilis, and Candida parapsilosis was observed, most of these species are commensal microorganisms of human skin. UPGMA dendrogram and PCoA biplot generated based on the microbial communities associated with all cellular phones exhibited build-up of specific communities on cellular phones and the prevalence of objectionable microorganisms in some of the cellular phones can be attributed to the poor hygiene and sanitary practices. The study also revealed the impact of MALDI-TOF MS spectral quality on the identification results. Overall MALDI-TOF appears a powerful tool for routine microbial identification and de-replication of microorganisms. Quality filtering of MALDI-TOF MS spectrum, development of better sample processing methods and enriching the spectral database will improve the role of MALDI-TOF MS in microbial identifications.

Presence of Multidrug-Resistant Bacteria on Mobile Phones of Healthcare Workers Accelerates the Spread of Nosocomial Infection and Regarded as a Threat to Public Health in Bangladesh

Recently, mobile phones have become a potent vector for the transmission of pathogens. In hospitals, the use of the mobile phones by healthcare workers in an unhygienic manner accelerates the spread of nosocomial infection. We aimed to investigate the prevalence of microbiological contamination of mobile phones belonging to clinicians in Bangladesh hospitals. From 100 samples, we identified 69 isolates of bacteria including 22 Staphylococcus aureus; 11 Pseudomonas aeruginosa; 14 Escherichia coli; 6 Salmonella typhi 6 and 16 Staphylococcus epidermidis. On the basis of antibiotic susceptibility test using 11 antibiotics, it has been observed that most of the isolated bacteria became resistant to antibiotics and compared to other isolates, isolates of S. epidermidis and S. typhi were more resistant and sensitive, respectively. About 68.8% isolates showed that their resistance capacities against ampicillin but in contrast, 56.6% isolated were susceptible to imipenem. Azithromycin and imipenem against S. aureus, gentamicin against P. aeruginosa, tetracycline and imipenem against E. coli, tetracycline against S. typhi, and S. epidermidis revealed significant antimicrobial affectivity. We found that mobile phones are potential vectors to spread antibiotic-resistant nosocomial pathogens. Based on the study, an effective disinfection practice for cellular phones used in hospitals should be introduced to prevent the potential of cross-contamination.

Efficacy of titanium dioxide nanoparticle spray to disinfect mobile phones used by endodontist: A bacteriological study

Aim:

The objectives of this study were to determine the bacterial contamination of the mobile phones that were used by the endodontist in comparison with the general dentist and also to determine the usefulness of titanium dioxide nanospray (TiO₂ NS) in mobile phone decontamination.

Materials and Methods:

Samples from the 60 mobile phones were taken using moist sterile swabs before, 10 min, and 1 week after the use of TiO₂ NS. Before collection of the swabs, the participants' informed consent was obtained. Samples obtained were cultured on blood agar to identify bacterial isolates.

Results:

All 60 mobile phone cultures were found to be culture positive. There was a significant reduction in the mean number of colony-forming units after decontamination with TiO₂ NS (P < 0.001).

Conclusions:

The results from this study showed that the mobile phones may act as an important source of nosocomial pathogens and TiO₂ NS would be an effective decontaminant. Therefore, it is important for dental professionals to practice routine mobile phone disinfection protocol to reduce the chances of occurrence of nosocomial infections.

Surface Microbiology of Smartphone Screen Protectors Among Healthcare Professionals

BACKGROUND

The use of smartphones with touch screens has become a norm for healthcare professionals (HCP). The risk of smart screen contamination has been proven, and guidelines are available to deal with possible contamination. A large number of smartphone users apply plastic or glass screen protectors onto their mobile phone screens to prevent scratches. However, these materials are not scratch proof, and their antipathogenic properties have not been studied.

METHODS

We have conducted a study to determine the frequency of smartphone screen protector contamination and compared the data with contamination on the bare area on the same mobile screens. The sample size included only HCPs working in acute care settings and having at least eight hours of exposure time every day.

RESULTS

A total of 64 samples were collected, which reported 62.5% (n = 40/64) positive culture swabs from the protected areas of the screen and 45.3% (n = 29/64) from the unprotected area of the screen. Micrococcus and Gram-negative rods grew only on samples taken from the protected area whereas the bare area showed no such growth. There was no statistically significant difference in the frequency based on smart screen size, duration of use during duty hours, or the setting where it was used.

CONCLUSIONS

Smartphone screen protectors from healthcare providers may harbor pathogenic bacteria, especially in acute care settings. Coagulase-negative Staphylococci followed by Bacillus species were the most commonly yielded bacteria among house officers and postgraduate trainees in the present study.