Vol 44 # 2 June 2012 - Kma.org.kw

June 2012
KUWAIT MEDICAL JOURNAL 102
MATERIAL AND METHODS
A prospective, cross-sectional analysis was
conducted in a 600–bedded teaching hospital. The
investigation was approved by the Ministry of Health
Ethics Committee and written informed consent
was obtained from the study participants. A total of
82 doctors’ mobile phones were tested during a two
months-period from June 16 th , 2009 to August 10 th ,
2009. The phones were swabbed in the middle of the
working day. The doctors were chosen randomly while
working in the wards, clinics, emergency department,
intensive care unit and operating rooms. The mobile
phones were tested with a wet sterile swab smeared
on the key pads, back and the sides of the phones. The
swabs were transferred to the microbiology laboratory
within one hour of collection.
The inoculations were made on sheep blood agar
plates which were incubated at 37 ºC overnight.
The bacterial isolates were subjected to preliminary
observations like colony characteristics, catalase,
oxidase, coagulase test and Gram staining. The final
identification for majority of the isolates was carried
out in MicroScan 96 automated system (Dade Behring,
West Sacramento, CA, USA) using Positive Combo 21
panels. However, Streptococcus viridans was identified
by conventional tests including resistance to optochin.
A data collection sheet was filled by each participant.
It included information about gender, speciality, usage
of mobile phones, frequency and method of cleaning
of the mobile phones and time and place of collection
of the sample.
RESULTS
Out of the eighty-two doctors who participated in
the study forty-eight (59%) stated that they use their
mobile phones most of the time compared to the use of
the hospital fixed phones. Sixty-seven (82%) of them
used the mobile phones for patient related issues. Fifty
(61%) of them stated that they do not clean the mobile
phone at all.
A total of 53 bacterial isolates were recovered from
40 mobile phones of the doctors. We did not isolate
any Gram negative bacterial species in our study. The
number of different bacterial species isolated is shown
in Table 1.
While 42 (79.25%) isolates were coagulase negative
staphylococci, only five (9.43%) were coagulase positive
(S. aureus). All the five S.aureus strains were sensitive
to the usual antibiotics (except one strain showing
resistance to erythromycin) including oxacillin as per
MicroScan report using Positive Combo 21 panels.
No S.aureus strain was found to be MRSA or MDRO.
Out of the 42 coagulase negative staphylococci 18
(42.86%) were S. epidermidis. Whereas, majority of the
mobile phones were colonized with only one bacterial
species, twelve showed growth of two or three species
/ strains.
Two S. aureus strains were isolated from the mobile
phones of two surgeons (one of them was working in
the OR at the time of collection). The remaining three
isolates of S.aureus were from a pediatrician, a physician
while working in the wards and from a nephrologist
while doing his rounds in the ICU. The two isolates of
Streptococcus viridans were from a physician and from
an obstetrician while working in the ward.
DISCUSSION
Mobile phones are part of the commonly used
patients care items and can serve as vectors for
pathogenic organisms. The use of mobile phones has
increased in the clinical setting and occurs in close
proximity to patients [1-5] . In a study from Australia,
mobile phones photo messaging was used for 27
cases of hand trauma for correspondence between
the registrar and the consultant in the emergency
department [12] . Our study also showed that majority
of doctors used their mobile phones more often than
the fixed phones and the use was mostly for patientrelated
issues.
The results of our study are in conformity with the
results of previous studies regarding the contamination
of doctors’ mobile phones with pathogenic bacteria [5-11] .
Similar to what was reported before, coagulase negative
staphylococci were the most commonly isolated species
which are known to produce nosocomial infections,
especially, in immunocompromised patients and in
certain wards like adults and neonatal intensive care
units.
We could not demonstrate any Gram negative
bacilli and enterococci in our study. This is similar
to what was documented in a previous study [1] . This
finding may be due to the fact that these organisms
usually need a moist environment for survival which
is not present on the surface of the mobile phones.
Table 1: Number of bacterial species isolated from doctors’ mobile phones
S. aureus
Coagulase Negative Staphylococci
S. epidermidis * Other Spp.
Streptococcus
viridans
Micrococcus and
related Spp,
Total isolates
5 18 24 2 4 53
* S. hominis 12, S. capitis 3, S. haemolyticus 3, S. auricularis 3, S. warneri 1, S. xylosus 1, S. cohnii 1