Abstract

ALVARES CALDERON, Tatiana; HERRERA ALVARADO, José Fabio  and  AVILA-AGUERO, María L. Estetoscopios: fuente potencial de infección nosocomial. Acta pediátr. costarric [online]. 2005, vol.19, n.1, pp.08-12. ISSN 1409-0090.

In Neonatal Intensive Care Units nosocomial infections are important cause of morbimortality. Different instruments can result contaminated by pathogens. The stethoscope takes more relevance because of its generalized use. They can transmit and expand al! kind of pathogens. Despite the recommendation to clean the stethoscopes before using them, this is not a generalized practice. Objectives: To detect the percentage of contaminated stethoscopes with bacteria. Quantify the reduction of this contamination in according with the use of different antiseptic substances. Evaluate the cleaning practice used by the owners of stethoscope in the National Children's Hospital of Costa Rica. Methods: Two cultures from the diaphragm of 112 stethoscopes of general use and exclusive use for each patient in the NICU were obtained. One base culture was performed to the stethoscope, and then repeated after cleaning it with one of three substances: alcohol, water and soap or water. The population was interrogated about the cleaning frequency of their stethoscope and about the information received concerning the stethoscopes. Results: 78% of the first cultures performed were positive for any germ. 80% of the physicians' stethoscopes were contaminated. After cleaning the instrument only 15% of the cultures were positive (p< 0,05). The percentage of stethoscopes with second cultures positive was less in the group that used soap and water (2/37.5%) in comparison with the group that used alcohol (9/40:22%) or only water (6/35:17%) (p=0,1). 100% of the cultures of stethoscopes from the NICU were positive for bacteria. The most isolated germ was Staphylococcus coagulase negative. 78% of the physicians refered to clean their stethoscopes, the majority sporadically (once a week or less). 77% of the physicians refered that they never received information or education about cleaning the stethoscopes. Conclusions: The high percentage of contaminated stethoscopes in the Children 's Hospital represents a potential source of nosocomial infection. The reduction of the positive cultures after cleaning the stethoscopes, shows the effectiveness of the action to reduce de risk of nosocomial infection independently of the antiseptic substance used. There is a lack of information in the physicians'staff about the importance of cleaning their stethoscope. That's why it's important to reinforce infection control programs and medical continuous education for complay asepsis and antisepsis norms

Keywords : Stethoscopes; nosocomial; contamination.