MRSA, Stethoscopes & Elmo
Clipped to the stethoscope of one of the physicians at the pediatric practice my family visits is a small Elmo. A small, grimy Elmo. The physician has mentioned on more than one occasion that he's had his furry friend since 1991. Looking at the worn Sesame Street character, I wasn't surprised. But I wasn't grossed out. I was actually pleased this doc made the extra effort to relate to and reassure kids. When your toddler is beset with ear infection after ear infection, as my son was a couple years ago, and you've got him in a near full nelson while the physician is examining his clogged ears with an otoscope, small distractions are wonderful.
Still, stethoscopes are tools where bacteria love to gather, particularly stethoscopes used in EDs. One in three stethoscopes from a sampling of emergency medical services (EMS) providers from New Jersey tested positive for methicillin-resistant Staphylococcus aureus (MRSA) in a recent UMDNJ study led by Dr. Mark Merlin, chair of the Mobile Intensive Care Unit Advisory Committee for the New Jersey Department of Health and Senior Services.
In the study, researchers swabbed 50 stethoscopes used by independent emergency medical service providers - including EMTs, nurses and paramedics - who visited a New Jersey hospital's ED with patients during a 24-hour period. Cultures were incubated for 72 hours and then analyzed by two emergency physicians and one microbiologist from UMDNJ.
Of the 50 stethoscopes, 16 had MRSA colonization, and the same number couldn't remember the last time their stethoscopes were cleaned.
Stethoscopes are known potential transmitters for MRSA. Still, Merlin was surprised by this study's results. "I thought maybe one percent of stethoscopes would be infected," he said.
Researchers suspect the length of time between stethoscope cleanings may increase the possibility of transmission. According to the study, the median reported length of time between cleanings was 1-7 days. "The longer period of time between cleanings, the more likely it is you have this bacteria," said Merlin, who also is an assistant professor of emergency medicine and pediatrics at the UMDNJ-Robert Wood Johnson Medical School.
What's the solution? EMS providers should clean their stethoscopes more frequently to prevent transmission of MRSA, Merlin urged.
"Provide isopropyl alcohol wipes at hospital emergency room entrances so EMS professionals can clean their stethoscopes regularly," said Merlin.