Nasal Colonization and Bacterial Contamination of Mobile Phones Carried by Medical Staff in the Operating Room

Chang CH, Chen SY, Lu JJ et al

PLoS One. 2017;12(5):e0175811. doi: 10.1371/journal.pone.0175811. eCollection 2017.

Aim of Study

Establish the incidence of bacterial contamination of mobile phones carried by medical staff in the operating theatre
To identify the potential relationship between this contamination and bacterial colonization of medical staff

Design and Location

Observational cohort study in Department of Orthopaedic Surgery, Operating Theatres Chang Gung Memorial Hospital, Linkou, Taiwan

Methodology

During “daily work” in the operating theatre
Swabs taken between every operation – 30 minutes after the case
All medical staff who gave written consent – mobile phone / anterior nare / dominant hand swabbed
Culture plates swabbed immediately.
Swabs cultured separately at 37°C for 48 hours
Control samples – Tip of a moistened swab cultured as above

Microorganisms identified
Flora defined as: Coagulation negative staphylococcus, Gram positive bacillus, Streptococcus spp., Moraxella spp, Gram negative bacillus
If staphylococcus aureus – pulsed-field gel electrophoresis were performed to identify the strain

Primary outcome

Assessing the overall bacteria positive rate of mobile phones / nares / dominant hands

Secondary outcome

Assess the specific microorganisms isolated on swabs
Assess the link between colonization of mobile phones / nares and dominant hands

Statistics

216 swab samples taken
72 medical-staff members included in the study
3 samples (nares, hands, MPs) per person

Results

Culture positive rate was 98.1% of these 27.3% of these were clinical pathogens.
The nose was most likely to have clinical pathogens
Staph aureus most commonly isolated pathogen12.5% MSSA (27/216), 7.4% MRSA (16/216)

70 people had “culture positive” mobile phones – 66 of these (94.3%) had the same micro organisms on their hands / nares
12 people had clinical pathogen “culture positive” mobile phones
10 of these (83.3%) had the same microorganism on their hands / nares

Conclusions

Nose is more commonly colonised than phones
Can hypothesize a link between phone colonisation and nose / hands
Authors recommend regulating use of mobile phones or regular “clean up” of phones

Stated Limitations

Their definition of normal flora include potentially infective organisms.
Genotyping was only performed for Staph. Aureus
No assessment of the relationship between colonizatiation of staff and surgical-site infections

Discussions and Conclusions from Journal Club Meeting

Relatively small numbers with nil powering of the study and nil thorough statistical analysis
The actual numbers who had genotyping of their bacteria were very low
Staff may have been more aware of their hygienic practice during the study
They are not specific about when samples were taken and nurses – scrub / theatre assistants
What about the anaesthetists?
Strong focus on staph aureus

The study certainly has its flaws but there is consistency in the literature
Further investigations into the effect of staff / phone colonisation on hospital acquired infections would be useful
Everyone should decontaminate their phones on a regular basis – particularly before touching patients. However this should be standard practice already

Summary by Dr E Gannon. Journal Club Meeting 26 April 2018.

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