Mobile phones as fomites for the transmission of ARBs in hospitals
Research type
Research Study
Full title
Mobile phones as fomites for the transmission of antibiotic resistant bacteria in hospitals
IRAS ID
233468
Contact name
Emma Joanne Hayhurst
Contact email
Sponsor organisation
University of South Wales
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Research Summary
Are the mobile phones of hospital staff harbouring antibiotic resistant bacteria? With the rise of antibiotic resistance in many of the bacteria which cause hospital-acquired infections, effective infection control within this setting is crucial. Increasing use of technology in hospitals has enhanced health care in many instances, but with the ubiquitous nature of mobile phones in our hospitals there is also now a need to assess the infection risks associated with these devices.This study will characterise the prevalence of drug resistant bacteria on staff mobile phones, and investigate their mechanisms and routes of transmission. Any staff working at Royal Gwent hospital who owns and uses a mobile phone will be eligible for inclusion in this study, which forms part of a KESS funded studentship. All data will remain anonymous.
Summary of Results
Mobile phones as fomites for potential pathogens in hospitals: microbiome analysis reveals hidden contaminants. Smartphones of 250 hospital staff and 191 control group participants were swabbed. The antibiotic resistance profile of Staphylococcus aureus and Enterococcus isolates was determined. Swabs were pooled into groups according to the hospital area staff worked in, and DNA was extracted. The microbial community of the phone was characterized using an Illumina MiSeq metabarcoding pipeline.
Almost all (99.2%) of hospital staff smartphones were contaminated with potential pathogens, and bacterial colony forming units (CFUs) were significantly higher on hospital phones than in the control group. Meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) were only detected on hospital mobile phones. Metabarcoding revealed a far greater abundance of Gram-negative contaminants, and much greater diversity, than culture-based methods. Bacillus spp. were significantly more abundant in the hospital group. This study reinforces the need to consider infection-control policies to mitigate the potential risks associated with the increased use of smartphones in clinical environments, and highlights the limitations of culture-based methods for environmental swabbing.
The second part of the study was to establish the survival rates of both pathogenic and non pathogenic bacteria found on hospitals phones on in order to establish the possibility of transmission of bacteria to different areas - including to hands of its users. Introduction Clinical use of mobile phones have increased exponentially. Whilst evidence of contamination is documented, a key factor when determining potential risks of contamination, is establishing the duration the organism remains viable on the device. If pathogens are found to persist for extended duration, healthcare mobile phones may become fomites for cross departmental transmission.
Aim Determine the duration pathogenic bacteria, Acinetobacter baumannii, Escherichia coli, two Pseudomonas sp. Bacillus cereus, Enterococcus faecalis susceptible and resistant to vancomycin (VSE and VRE) Staphylococcus aureus susceptible and resistant to methicillin (MSSA and MRSA), and a coagulase negative Staphylococcus (CoNs) can remain viable on a mobile phone under controlled conditions.
Method Phones were inoculated with 106 – 107 of each bacterium. The duration of viability was measured from the point the inoculum had dried and CFUs retrieved at timed intervals over 28 days.
Results. The mean percentage of bacteria viable at each time point was significantly different (20mins, p=0.004, 1hour p=0.014, 6hours p = 0.006, 24hours p=0.004, 7 days p = 0.007, 14 days p = 0.003, 21 days p = 0.002- and 28-days p =0.004). Gram-positive bacteria remained viable longer than gram-negative bacteria (p=0.010). MSSA declined faster than MRSA within the first 6 hours (p=0.036).
Conclusion – The extended duration of bacterial viability indicates the ability for pathogens to persist on a device and remain viable long enough to be transmitted to new areas both within the hospital and out to the community. Mobile phone decontamination should occur in combination of hand hygiene.Publication can be found https://eur03.safelinks.protection.outlook.com/?url=http%3A%2F%2Furl6570.hra.nhs.uk%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbaNKhM2veQCpNbb8U3lc6HRwuN0g-2B0S17jhGlA5nN7XPaE5vwPAFSJ-2FV8Hn-2Fg9o8ZQ-3D-3D7kQj_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YI-2B0yAgDt0lYK9P9W4BMwQ5EqBjfnQfe8JGc9MLzh-2BNujE83VgZmFfvy9Bd6T9pZ7cL9GNgoOIL-2Bbmz-2FKq25StCf2UzYm19uwiIQ2U2XBQsli9A8tvQ7qYOM6z40-2Bqsr3Uw8CJ-2FVwJMXmhUOwK-2B2jm7wOMnOFs1EacMvXc6JMFn8D2PrrUAs4HD9gUNUV-2B4DvA-3D&data=04%7C01%7Capprovals%40hra.nhs.uk%7Cd1b9709d9cfd423bed3108d98e37a25f%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637697191856159818%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=jp9h2JrRhb1x4be584%2Feu1sJgpC4g4LLE7mrqBbyOLU%3D&reserved=0
r.simmonds et al (2019)
REC name
Wales REC 4
REC reference
17/WA/0413
Date of REC Opinion
12 Dec 2017
REC opinion
Favourable Opinion