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Submitted on 12 Apr 2019
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World Health Organization “SAVE LIVES: Clean Your
Hands” global campaign
S. Boudjema, P. Brouqui
To cite this version:
S. Boudjema, P. Brouqui. World Health Organization “SAVE LIVES: Clean Your Hands” global
cam-paign. Clinical Microbiology and Infection, Elsevier for the European Society of Clinical Microbiology
and Infectious Diseases, 2018, 24 (4), pp.442. �10.1016/j.cmi.2017.10.031�. �hal-01780656�
Letter to the Editor
World Health Organization
“SAVE LIVES: Clean Your Hands” global campaign
We read with interest the commentary by Tartari et al. on the 5 May 2017‘Clean Your Hands’ global campaign[1]. This campaign focused onfighting antimicrobial resistance though promotion of an effective infection prevention and control programme by the means of hand hygiene. Although we completely agree with Tarta-ri's comments, we wanted to emphasize that contaminated fomites must also be targeted in such a campaign, as their role in transmis-sion of microorganisms including some multiresistant, is far from negligible [2]. Among them, stethoscopes are potential vectors with a high degree of microbial contamination [3]. They have been recognized as a source of nosocomial outbreaks[4]. The dia-phragm part of the stethoscope, which comes into contact with the patient's skin, could be a reservoir for infectious agents. The mean rate of contamination of stethoscopes has been reported at 85% (range 47-100%) [5]. Cleaning stethoscope diaphragms with either ethanolebased cleanser or isopropyl alcohol leads to a signif-icant reduction in bacterial growth. As an extension of the hand, stethoscopes should be cleaned as often as the hands[6]. Availabil-ity of disposable stethoscope covers (Stethocap) should also be promoted.
Beside patient care items, mobile phones are devices often used by healthcare workers and physicians and should be frequently cleaned. Bacterial contamination of mobile phones is common and might have an impact on the efficiency of infection control measures [7,8]. Brady et al. report that 84.3% of mobile phones are contaminated, 11.8% of them with bacteria responsible for noso-comial infections[9]. Ulger et al. report that among the 39 studies published between 2005 and 2013 on mobile phone contamina-tion, 19 (48.7%) identified coagulase-negative staphylococci (CoNS) and 26 (66.7%) identified Staphylococcus aureus. Restricting the use of mobile phones in hospitals would appear to be unrealis-tic. Regular training of healthcare workers about mobile phones as a potential source of transmission of nosocomial infections, using a multimodal approach (e.g. oral, visual information), and available disposable mobile phone protectors should be promoted.
Among many other fomites, it is important to raise awareness among healthcare workers that blood pressure cuffs and oximeter sensors are potential vectors for pathogenic agents and must be disinfected. We should complete our hand hygiene campaign by focusing on patients’ and care personnel's fomites, notably by asking healthcare workers to avoid the use of certain fomites (e.g. mobile phones), to regularly clean the others (cuffs, oximeters), to
regularly change their coats, and not to wear ties, an obvious hy-gienic attitude.
Transparency declaration
The authors do not have any conflict of interest concerning the work under consideration. PB is founder in part of the Medihand-trace® StartUp. No external funding was received for this work. References
[1]Tartari E, Abbas M, Pires D, de Kraker MEA, Pittet D. World Health Organization SAVE LIVES: Clean Your Hands global campaign-'Fight antibiotic resistance-it's in your hands'. Clin Microbiol Infect 2017;23:596e8.
[2]Kanamori H, Rutala WA, Weber DJ. The role of patient care items as a fomite in healthcare-associated outbreaks and infection prevention. Clin Infect Dis 2017;65:1412e9.
[3]Longtin Y, Schneider A, Tschopp C, Renzi G, Gayet-Ageron A, Schrenzel J, et al. Contamination of stethoscopes and physicians' hands after a physical examina-tion. Mayo Clin Proc 2014;89:291e9.
[4]Gastmeier P, Groneberg K, Weist K, Ruden H. A cluster of nosocomial Klebsiella pneumoniae bloodstream infections in a neonatal intensive care department: identification of transmission and intervention. Am J Infect Control 2003;31: 424e30.
[5]O'Flaherty N, Fenelon L. The stethoscope and healthcare-associated infection: a snake in the grass or innocent bystander? J Hosp Infect 2015;91:1e7. [6]Lecat P, Cropp E, McCord G, Haller NA. Ethanol-based cleanser versus isopropyl
alcohol to decontaminate stethoscopes. Am J Infect Control 2009;37:241e3. [7]Goldblatt JG, Krief I, Klonsky T, Haller D, Milloul V, Sixsmith DM, et al. Use of
cellular telephones and transmission of pathogens by medical staff in New York and Israel. Infect Control Hosp Epidemiol 2007;28:500e3.
[8]Ulger F, Esen S, Dilek A, Yanik K, Gunaydin M, Leblebicioglu H. Are we aware how contaminated our mobile phones with nosocomial pathogens? Ann Clin Microbiol Antimicrob 2009;8:7.
[9]Brady RR, Verran J, Damani NN, Gibb AP. Review of mobile communication de-vices as potential reservoirs of nosocomial pathogens. J Hosp Infect 2009;71: 295e300.
S. Boudjema, P. Brouqui* IHU Mediterranee Infection, URMITE, AMU, France
*Corresponding author. P. Brouqui
E-mail address:philippe.brouqui@univ-amu.fr(P. Brouqui). 27 September 2017 Available online 4 November 2017 Editor: L. Leibovici Contents lists available atScienceDirect
Clinical Microbiology and Infection
j o u r n a l h o m e p a g e : w w w . c l i n i c a l m i c r o b i o l o g y a n d i n f e c t i o n . c o m Clinical Microbiology and Infection 24 (2018) 442
https://doi.org/10.1016/j.cmi.2017.10.031
