Doctors and dirty stethoscopes

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Doctors and dirty stethoscopes: Why is nobody listening?

Doctors are failing to take action on bug-infested stethoscopes.

By F. Winter Last Updated: 9:55AM GMT 15 Dec 2008

From the day in 1816 when French physician René Laennec rolled up 24

sheets of paper and used le cylindre to listen to the chest of a

female patient, the monaural stethoscope has evolved into the modern

stereo versions – some of which now come complete with built-in MP3

players and trendy ringtones.

Yet, as a report in a journal asks this month, how safe is this

ubiquitous implement? There are few doctors from whose necks this

device doesn't dangle, but they are often a breeding place for bugs –

not helped by the behaviour of doctors both on and off the wards...

As far back as 1972, it was known that stethoscopes posed an infection

hazard; a report in the medical journal The Lancet detailed how

researchers had collected 100 stethoscopes from various departments in

a London teaching hospital and found bugs on all of them, with 21

carrying staphylococci, one of the bacteria that cause food poisoning.

Nine of these bugs were resistant to two or more antibiotics, with one

resistant to penicillin, tetracycline and meticillin. Yet the authors

(Gerken et al) discovered that the infection risk could be eliminated

very simply – by wiping the bell and diaphragm of the instrument with

disinfectant after use on each patient...

In this month's issue of the Journal of Infection, researchers from

Sandwell General Hospital, West Bromwich: " How clean are our

stethoscopes, and do we need to clean them? " The answers – surprise,

surprise – are " not very " and " yes " . This time, 40 stethoscopes were

sampled, 37 of which harboured bugs: one had skin and intestinal

bacteria, one had staphylocci and one, from the labour ward theatre,

yielded a pure growth of Group B streptococcus – a major cause of

infection for women and infants.

The authors conclude: " It is advisable to clean the diaphragm of the

stethoscope regularly, using 70 per cent alcohol, in order to reduce

the bacterial load effectively and hence prevent potential

transmission to patients. " ...

In the grand scheme of things, I can't say I'd be particularly

bothered if a doctor listened to my chest using a stethoscope

rorschached in macaroni cheese – but I'd prefer to think that a dab of

alcohol had helped make it bug-free. I hope I'm wrong, but I have a

feeling that in 30 years' time yet another study will confirm what was

known decades previously – but still have not been acted upon.

F Winter is a Fellow of the Institute of Biomedical Science and

a former senior biomedical scientist in the virology laboratories at

Edinburgh City Hospital and Edinburgh Royal Infirmary.

http://www.telegraph.co.uk/health/3725133/Doctors-and-dirty-stethoscopes-Why-is-\

nobody-listening.html