Becker's Clinical Quality & Infection Control

16 Special Focus on Infection Prevention Stethoscopes: New Culprit in MRSA Transmission By Akanksha Jayanthi S tethoscopes may be the next target for cracking down on methicillin-resistant Staphylococcus au- reus. A study in Mayo Clinic Proceedings found that after a physi- cian visits a patient, their stethoscopes are more contami- nated than certain parts of their hand. Researchers took cultures of the bacteria on the hands and stethoscopes of physicians after a standard physical exami- nation. They collected cultures from the stethoscope dia- phragm and tube and physicians' fingertips, either side of the palm and the back of the hand. Both the stethoscope diaphragm and tube had a higher total bacterial count than either side of the palm and the back of the hand. Only the fingertips had a higher average bacterial count. When researchers screened exclusively for MRSA bacteria, average counts were similar for the stethoscope diaphragm and the fingertips, suggesting physicians transfer bacteria to their stethoscope when they touch it, according to a Smithsonian report on the study. Didier Pittet, MD, lead physician on the World Health Organization's Global Patient Safety Challenge initiative and researcher in the study, suggested the high levels of stethoscope contamination may stem from hand hygiene practices. "Physicians forget to clean their hands quite frequently, even in the best places," Dr. Pittet said in the Smithsonian report. "When they forget to clean their hands, they certainly forget to disinfect their stethoscope. And from my experience, even those who are really good models of hand hygiene likely for- get to clean their stethoscopes most of the time." Dr. Pittet suggests more research is needed on understand- ing the risk of bacterial transmission from an unsterilized stethoscope. n Study: Healthcare Professionals' Definitions of 'Multidrug-Resistant' Vary By Ellie Rizzo W hen it comes to describing multidrug-resistant organisms, healthcare workers can't seem to agree on a definition, according to research published in Infection Control and Hospital Epidemiology Researchers surveyed members of the Society for Healthcare Epidemiology of America from 26 states and 15 countries on their experiences with and definitions of MDR En- terobacteriaceae, Acinetobacter and Pseudomonas species of bacteria in acute-care settings. Researchers found the reported definitions of an MDR organism were highly variable, with 14 unique definitions for Acinetobacter, 18 unique definitions for Pseudomonas and 22 unique definitions for Enterobacteriaceae isolates. In addition, the procedures for dealing with patients infected with MDR organisms varied greatly. While patients with methicillin-resistant Staphylococcus aureus and van- comycin-resistant Enterococcus were usually placed in isolation, 20 percent of facilities did not place patients with MDR Acinetobacter and Pseudomonas species in isolation. Criteria for isolating patients with any MDR organism were highly variable, according to the article. Researchers suggested that while acute-care settings have fairly standardized procedures for dealing with cases of MRSA and VRE, the general confusion over the definition of an MDR organism and how and when to quarantine infected patients could be taking a toll on the effectiveness of infection control efforts. n SAVE THE DATE! Becker's Hospital review CEo Strategy roundtable November 5, 2014 Ritz Carlton Hotel, Chicago 40 Hospital & Health System CEos Speaking Co-chaired by Scott Becker, Publisher, Becker's Hospital Review, and Chuck Lauer, Former Publisher, Modern Healthcare To learn more visit www.BeckersHospitalreview.com To register, visit www.regonline.com/ceoroundtable2014 get the latest Infection Control Tips In Your Inbox To sign up, visit www.beckersinfectioncontrol.com Becker's Infection Control & Clinical Quality E-Weekly

• Cover