Rajput, Farooq, Singh, Sharma, Sharma, Ahamad, Nudrat, and Mohan: Study of microbial contamination of mobile phones of healthcare workers (HCWs)


Introduction

In order to provide an enhanced communication network, the worldwide infrastructure for mobile phones and telecommunication was developed in 1982 in Europe. In the modern-day scenario, Asia has the fastest growing number of mobile phone subscribers in the world. Around 75% of the world’s adults have the access to mobile phones.1

Mobile phones may act as fomites and may facilitate the transmission of microorganisms from one patient to another in the hospital during their treatments.

These mobile phones are now described as technical Petri dishes where they could play a role in health-related infections as they spread through the hands of healthcare staff.2

The human skin most frequently remains in the contact with the microorganisms and thus quickly infected by certain microbes. The human skin wrapped about 2m with the supporting surface area approximate 1012 bacterial count per person through a single mobile phone call, the mobile phone comes in direct interaction with certain areas of Infected human body, such parts are ear, hand, mouth, and nose which may result in settlement by possible pathogens which are present on human skin and mobile phones.3

Mobile phone contamination can occur through several sources such as handbags, pockets, food, human skin, bags, and other environmental practices. As the previous literature suggests that mobile phones were found to keep a large number of microorganisms because some bacteria grow at elevated temperatures and phones are breeding place for these microorganisms as they are kept safe and secure in our handbags and pockets.1

The infected hands of healthcare workers (HCWs) play a crucial role in the spread of the disease in the health care premises (HCPs).

The continuous use of mobile phones by health care workers makes it an available place for microorganism’s transmission activity as well as for hospital acquired infections.

Ethics approval

Ethics approval was obtained from TMMC Moradabad institutional Ethics Committee (TMMC-IEC) Ref. No. TMMC & RC /IEC/18-19/082r.

Material and Method

Sample collection

The samples were taken by swab stick from the mobile phones of health care workers working in critical areas-ICUs, Emergency & casualty and OTs.

The sample were then inoculate on nutrient agar, blood agar, macConkey agar plates. Plates were incubated for 24 hours at 370 c, after 24 hours of incubation the culture plates were examined for growth, gram staining, colony characteristics & biochemicals.

Conventional tests for identification of bacteria

Organisms grown were identified by their –

A- Culture media    

1- Nutrient agar.

2- Blood agar

3- MacConkey agar

B-Culture characteristics

C- Gram’s staining of the isolated colonies.

D- Identification by enzymatic or rapid test & biochemical test.

Results

A total number of 134 samples was included, in this study mobile phones of healthcare workers from the various area’s ICUs, OTs & Emergency & Casualty were collected and examined.

Table 1

Shows total no of positive and no of negative sample (N=134)

Total sample

No. of positive sample

No. of negative sample

134

132

02

This table reveals that out of 134 mobile phones, 132 showed the growth of the bacterial pathogen in a significant amount and 2 were negative, so the overall contamination of the mobile phones was found to be 98.50% and no growth was found to be 1.49%.

Table 2

Shows types of colonies grown on the mobile phone of health care workers (N=134)

Total no of sample

No growth

Single/pure growth

Mixed type of growth

134

02

124

08

Table 3

Shows Different organism isolated from different Health care workers working in critical areas of hospital (N=124)

Bacteria isolated from health care workers

No of bacteria isolated

Staphylococcus aureus (MRSA)

62

Staphylococcus aureus

33

Pseudomonas spps

11

Klebsiella peumoniae

9

E.Coli

6

Acinetobacter calcoaceticus baumani complex

2

Klebsiella peumoniae (ESBL)

1

Table 4

Shows distribution of organism isolated from different areas of hospital.(N=126)

Area of hospital

Total no of samples

Samples having growth

Samples having no growth

Percentage %

MICU

5

5

0

3.96%

ICCU

18

16

02

14.28%

SICU

13

13

0

10.31%

Emergency & casualty

48

48

0

38.09%

Neuro ICU

9

9

0

7.14%

Major OT

19

19

0

15.32%

Gynae OT

14

14

0

11.29%

Discussion

Medical infection outbreak is a major emerging concern in many hospitals and health centres. Medical environment plays a critical role in the propagation of the hospital acquired infection related organisms. The microorganisms can be transmitted from one individual to another and mobile phones are the most extensively used devices and serve as a common mechanism for transporting microorganisms from mobile phones to hands.4 Health care workers (HCWs) mobile phones can serve as a source for the transmission of nosocomial infections from one patient to another in a health care facility.5 Mobile phones now are appropriate devices for health care staff to carry over illness from patient to patient.6

The aim of our research was to examine the contamination of mobile phones that are carried by health care workers serving in sensitive areas. Mobile phones are used without any restriction in the hospital which makes them a potential reservoir of bacterial pathogens. In our study, the microbial contamination of phones used by health care workers in critical areas of the hospital was collected. We had swabbed the phones of 134 health workers in our hospital and 98.50 % of the bacterial infection was observed. Gashaw et al7 had described the bacterial contamination of mobile phones of healthcare workers as 98.3% which corresponded to our study. Similarly, studies conducted by Bhat ss et al,8 Rao SJP et al9 and Shakthivel GPC et al10 reports the nosocomial infections as 99 %, 92 % and 90 %. Which shows the slight difference between them and our study.

The study conducted by Arora U et al11 and Elmanama A et al12 had reported microbial contamination with different bacteria as 91.60% and 90.9%. which is less than our study (98.50%) thus the studies are concluded unsimilar to our study. Thus, these result implies that the microbial contamination of cell phones will serve as a pathogen source that can be rapidly spread through mobile phones to the hands of the health care worker and passed to the patient's body during the assessment of the patients. Whenever a phone call has been made the phone comes in close contact with the human hand. Later these bacteria can be spread to susceptible parts of the human body, such as the nose, throat, ear and eyes.13 Mobile phones in various ICUs, OTs, or hospitals can quickly transfer bacterial isolates. 13

In our study Staphylococcus aureus (MRSA) 62 (50%) was the most predominant isolates followed by Staphylococcus aureus 33(26.61%), Pseudomonas spps 11(8.87%), Klebsiella pneumonia 9(7.25%), E.Coli 6(4.83%), Acinetobacter calcoaceticus baumani complex 2(1.61%), Klebsiella peumoniae (ESBL)1(0.80%).

A identical study was done out by Shahlol AMA et al14 14 they found the most predominant bacterial isolates were Methicillin resistant Staphylococcus aureus 35 %, Bacillus spp. 33.5 %, Staphylococcus. Albus 22.85%, Escherichia. Coli 8.57 %.

Similarly, Subhedar V et al15 reported that 75(69.44%) were Staphylococcus aureus (MRSA 35.18%, MSSA 34.26%), 14.81 were Staphylococcus epidemidis, 28.70% Moraxella sp, 29.63% Aerobic bacilli, 1.85% Micrococcus Sp, Acinetobacter sp and Psedomona ssp and 9.92% Klebsiella sp. 43 of 108(39.8%).

Conclusion

The most predominant bacteria were Staphylococcus aureus MRSA in our study. It may be due to MRSA residue in the nose, when it comes to our hand then individuals get exposed to cross infection.

  1. The dominance of clinical phones that could be contaminated by different microorganisms inside the ICUs and OTs has become unacceptable.

  2. There is no rules and regulation for staff to carry their phone in sterile area like OTs, ICUs. Study showed there is no cleaning guidelines for the mobile of health care workers.

  3. Active preventive measures and strategy should be followed

  4. Measures to control the hospital acquired infection are -

Standard precautions

  1. Hand hygiene practice

  2. Personalprotective equipment’s (PPE like gloves, mask, gown, face shields

  3. Injection safety

  4. Environmental cleaning

  5. Spillage cleaning

  6. Medical equipment’s-glucose meter and other care devices, endoscope and surgical instruments should be clean before and after use to patients.

  7. Respiratory hygiene

  8. Sharp handling- all sharps including needle should be handled with extreme care

  9. Biomedical waste management

  10. Isolation-

Conflicts of Interest

All contributing authors declare no conflicts of interest.

Source of Funding

None.

References

1 

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R R Morubagal G S Shivappa Mahalepr M S Neelambike Study of bacterial flora associated with mobile phones of healthcare workers and non health care workersIran J Microbiol20179314351

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A Shahlol HM Khalifallah E Shahlol Bacterial contamination of Mobile phones and Hands of Health care workers in Sabha Medical Center Hospital, Fazzan Area in South western of LIBYAInt J Curr Res Med Sci20151418

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