Monday, September 12, 2016

Stethoscope Decontamination- What Works Best?

Last week I did an interview for Medscape on healthcare worker contamination (hands, clothes, instruments) and its impact on potential cross-transmission of pathogens to patients. Although the proportionate impact of apparel and stethoscopes on infections is unknown, it is generally believed that 20%-40% of all hospital acquired infections are due to cross transmission from the inanimate environment.

It is well known that healthcare worker apparel can carry a significant bioburden, as summarized here in this SHEA Expert Guidance paper. Stethoscopes, too, become colonized with pathogens such as MRSA.

Many (myself included) advocate wiping down stethoscopes between cases.This is typically done with alcohol wipes. This recent article in the American Journal of Infection Control suggests that chlorhexidine (CHG) would be a better option for stethoscope disinfection as the residual effect CHG can inhibit stethoscope re-contamination for up to 4 hours. Simple and easy with a potential benefit of enhanced bioburden reduction.

Perhaps it is time for us to rethink our disinfectant of choice for stethoscopes.