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Stethoscopes as vectors of multi-resistant coagulase negative staphylococci in a tertiary hospital

Foteini Leontsini, Aris Papapetropoulos, Apostolos Vantarakis.

Background: Stethoscopes are an essential tool for physicians, but can be a source of hospital infections.

Aims & Objective: The objective was to isolate staphylococci strains from the diaphragms and earpieces of the stethoscopes as well as to characterize their antibiotic resistance.

Material and Methods: Forty five stethoscopes from different clinical doctors were sampled in a tertiary hospital. The swab method was used and the swabs were immediately inoculated on blood agar and manitol salt agar. The bacterial identification and the antibiotic resistance were performed according to the CLSI with automated commercial system.

Results: Pathogenic or potential pathogenic Coagulase Negative Staphylococci (CoNS) were isolated on physician’s stethoscopes. CoNS were isolated in 87.6% of the stethoscopes. S.epidermidis was the predominant isolate species of CoNS (39.4%) followed by S.hominis (19.7%), S.auricularis (9.8%), S. haemolyticus (8.4%), S.warneri (7%), S. cohnii (5.6%), S. lugdunensis (4.2%), S. capitis (4.2%), S.hyicus (1.4%). The isolated CoNS have high resistance rate in penicillin (74.6%), antibiotic macrolidess (60.5%), clindamycin (39.4%), oxacillin (30.9%) and gentamycin (22.4%). The co-resistance of S.epidermidis for methicillin-gentamicin was 59.2%. Multi-resistant strains of CoNS were 16.9% and belong to the species of S.epidermidis, S.hominis and S.haemolyticus.

Conclusion: The study demonstrates the contamination of the stethoscopes with different species of CoNS which showed high antibiotic resistance and possess the potential risk of causing hospital infections. As severe hospital infections, especially in population at risk caused by different species of CoNS, are increasing; their characterization at the species level as well as their resistance pattern in patients and medical devices is strongly suggested.

Key words: Antibiotic resistance, Coagulase-negative Staphylococci (CoNS), Contamination, Hospital infections, Stethoscopes.

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