Methods of Disinfecting Stethoscopes: Systematic Review

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2020 Mar 19

PMID 32182989

Citations 7

Authors

Margherita Napolitani

Daiana Bezzini

Fulvio Moirano

Corrado Bedogni

Gabriele Messina

Affiliations

Soon will be listed here.

Abstract

The aim of this systematic review was to investigate the effectiveness of various disinfection methods available for stethoscopes. In March 2019, we performed a search in PubMed and Scopus using the search terms: "reducing stethoscopes contamination" and "disinfection stethoscopes"; the Mesh terms used in PubMed were "Decontamination/methods" or "Disinfection/methods" and "Stethoscopes/microbiology". Selection criteria were: English language; at least one disinfection method tested. A total of 253 publications were screened. After title, abstract, and full-text analysis, 17 papers were included in the systematic review. Ethanol at 90%, Ethanol-Based Hands Sanitizer (EBHS), triclosan, chlorhexidine, isopropyl alcohol, 66% ethyl alcohol, sodium hypochlorite, and benzalkonium chloride have been proven to lower the presence of bacteria on stethoscopes' surfaces. In addition, alcohol wipes show effective results. A wearable device emitting ultraviolet C by Light-Emitting Diode (LED) resulted efficacious against common microorganisms involved in Healthcare Associated Infections. The cover impregnated with silver ions seemed to be associated with significantly higher colony counts. Instead, copper stethoscopes surface reduced bacterial load. The disinfection of stethoscopes appears to be essential. There are many valid methods available; the choice depends on various factors, such as the cost, availability, and practicality.

Citing Articles

Implementation of stethoscope disinfection: an observational study on nursing staff practice and knowledge.

Sahan S, Guler S, Korkmaz E GMS Hyg Infect Control. 2024; 19:Doc30.

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A clinical study to evaluate the safe and effective use of a new, single use stethoscope cover to enable reduction in pathogen transmission during auscultation.

Nazari-Shafti T, Meyborg H, Iske J, Schloss M, Seeber F, Friedrich A Front Med (Lausanne). 2023; 10:1179145.

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Impact of alcohol-based hand-rub disinfection on bacterial bioburden on stethoscopes in a real-world clinical setting.

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References

Parmar R, Valvi C, Sira P, Kamat J . A prospective, randomised, double-blind study of comparative efficacy of immediate versus daily cleaning of stethoscope using 66% ethyl alcohol. Indian J Med Sci. 2004; 58(10):423-30. View

Hill C, King T, Day R . A strategy to reduce MRSA colonization of stethoscopes. J Hosp Infect. 2005; 62(1):122-3. DOI: 10.1016/j.jhin.2005.03.013. View

Sengupta S, Sirkar A, Shivananda P . Stethoscopes and nosocomial infection. Indian J Pediatr. 2000; 67(3):197-9. DOI: 10.1007/BF02723663. View

OFlaherty N, Fenelon L . The stethoscope and healthcare-associated infection: a snake in the grass or innocent bystander?. J Hosp Infect. 2015; 91(1):1-7. DOI: 10.1016/j.jhin.2015.04.010. View

OGorman J, Humphreys H . Application of copper to prevent and control infection. Where are we now?. J Hosp Infect. 2012; 81(4):217-23. DOI: 10.1016/j.jhin.2012.05.009. View

Schmidt M, Tuuri R, Dharsee A, Attaway H, Fairey S, Borg K . Antimicrobial copper alloys decreased bacteria on stethoscope surfaces. Am J Infect Control. 2017; 45(6):642-647. DOI: 10.1016/j.ajic.2017.01.030. View

Messina G, Rosadini D, Burgassi S, Messina D, Nante N, Tani M . Tanning the bugs - a pilot study of an innovative approach to stethoscope disinfection. J Hosp Infect. 2017; 95(2):228-230. DOI: 10.1016/j.jhin.2016.12.005. View

Ghumman G, Ahmad N, Pop-Vicas A, Iftikhar S . Stethoscope Cleaning During Patient Care. R I Med J (2013). 2018; 101(4):18-20. View

Wood M, Lund R, Stevenson K . Bacterial contamination of stethoscopes with antimicrobial diaphragm covers. Am J Infect Control. 2007; 35(4):263-6. DOI: 10.1016/j.ajic.2006.09.004. View

10.

Wenzel R, Thompson R, Landry S, Russell B, Miller P, Ponce de Leon S . Hospital-acquired infections in intensive care unit patients: an overview with emphasis on epidemics. Infect Control. 1983; 4(5):371-5. DOI: 10.1017/s0195941700059774. View

11.

Messina G, Fattorini M, Nante N, Rosadini D, Serafini A, Tani M . Time Effectiveness of Ultraviolet C Light (UVC) Emitted by Light Emitting Diodes (LEDs) in Reducing Stethoscope Contamination. Int J Environ Res Public Health. 2016; 13(10). PMC: 5086679. DOI: 10.3390/ijerph13100940. View

12.

Sahiledengle B . Stethoscope disinfection is rarely done in Ethiopia: What are the associated factors?. PLoS One. 2019; 14(6):e0208365. PMC: 6597050. DOI: 10.1371/journal.pone.0208365. View

13.

Boulee D, Kalra S, Haddock A, Johnson T, Peacock W . Contemporary stethoscope cleaning practices: What we haven't learned in 150 years. Am J Infect Control. 2018; 47(3):238-242. DOI: 10.1016/j.ajic.2018.08.005. View

14.

Vasudevan R, Shin J, Chopyk J, Peacock W, Torriani F, Maisel A . Aseptic Barriers Allow a Clean Contact for Contaminated Stethoscope Diaphragms. Mayo Clin Proc Innov Qual Outcomes. 2020; 4(1):21-30. PMC: 7010972. DOI: 10.1016/j.mayocpiqo.2019.10.010. View

15.

Mehta A, Halvosa J, Gould C, Steinberg J . Efficacy of alcohol-based hand rubs in the disinfection of stethoscopes. Infect Control Hosp Epidemiol. 2010; 31(8):870-2. DOI: 10.1086/655437. View

16.

Leprat R, Minary P, Devaux V, de Waziere B, Dupond J, Talon D . Why, when and how to clean stethoscopes. J Hosp Infect. 1998; 39(1):80-2. DOI: 10.1016/s0195-6701(98)90250-x. View

17.

Messina G, Spataro G, Rosadini D, Burgassi S, Mariani L, Tani M . A novel approach to stethoscope hygiene: A coat-pocket innovation. Infect Dis Health. 2024; 23(4):211-216. DOI: 10.1016/j.idh.2018.06.002. View

18.

Marinella M, Pierson C, Chenoweth C . The stethoscope. A potential source of nosocomial infection?. Arch Intern Med. 1997; 157(7):786-90. DOI: 10.1001/archinte.157.7.786. View

19.

Alvarez J, Ruiz S, Mosqueda J, Leon X, Arreguin V, Macias A . Decontamination of stethoscope membranes with chlorhexidine: Should it be recommended?. Am J Infect Control. 2016; 44(11):e205-e209. DOI: 10.1016/j.ajic.2016.07.012. View

20.

Lee Y, Chen S, Lee M, Hung H, Huang H, Lin H . Time-series analysis of the relationship of antimicrobial use and hand hygiene promotion with the incidence of healthcare-associated infections. J Antibiot (Tokyo). 2012; 65(6):311-6. DOI: 10.1038/ja.2012.20. View