Mobile Phones and Multidrug Resistant Bacteria: A Growing Concern for Healthcare Workers

Nagat Elbarghathi; Hoda Ahwaide; Masoud Eldernawi; Mohammed Abdulmawlay

doi:10.69667/lmj.2517113

Authors

Nagat Elbarghathi Department of Pharmacology, Faculty of Medicine, University of Benghazi, Benghazi, Libya https://orcid.org/0009-0006-6870-0857
Hoda Ahwaide Department of Pharmacology, Faculty of Medicine, University of Benghazi, Benghazi, Libya https://orcid.org/0000-0001-8352-6822
Masoud Eldernawi Benghazi Medical Centre, Benghazi, Libya https://orcid.org/0009-0004-6815-816X
Mohammed Abdulmawlay Benghazi Medical Centre, Benghazi, Libya https://orcid.org/0009-0000-4859-4037

DOI:

https://doi.org/10.69667/lmj.2517113

Keywords:

Multidrug Resistance, Bacteria, Mobile Phones, Healthcare Workers, Antibiotics.

Abstract

Healthcare workers' mobile phones can potentially transmit a range of pathogenic bacteria causing Hospital acquired infections to patients and community. The study was conducted to determine the prevalence of bacterial contamination of mobile phones of healthcare workers, assessing the kinds of bacterial isolates, their antibiotic susceptibility and resistance patterns, and the factors contributing to contamination. A cross-sectional study was conducted at Elhwari Nephro Center including 125 health care workers. Demographic data, and data regarding antibiotic usage history as well as mobile cleaning behaviour were collected using a structured questionnaire. Antimicrobial susceptibility testing was performed for all the collected mobile swabs samples. Data analysis using SPSS version 28. Prevalence rates of resistant micro-organisms were revealed together with the corresponding patterns of antibiotic susceptibility. Results are presented using tables for clarity. The overall prevalence of mobile phone contamination was 84% of swabbed samples. The most common bacterial isolate was pseudomonas aeruginosa 21.6% followed by E. coli 20.8%, staphylococcus epidermidis 16.8%, Klebsiella pneumonia 14.4%, staphylococcus aureus 6.4%, and clostridium spp 4%. Most isolates were susceptible to levofloxacin (98.1%), ciprofloxacin (88.6%), and ceftriaxone (84.8%). Vancomycin showed limited effectiveness specifically against staphylococcus aureus with only 13% susceptibility. 86.7% and 71.2% of bacterial isolates were resistant to erythromycin and clindamycin respectively. No significant correlation was found between mobile phone contamination and different participant variables such as gender, age, occupation, mobile phone usage and hygiene practices. The overall prevalence of multidrug-resistant bacteria was 80%. This study points out the scary role that mobile phones play in the dissemination of multidrug-resistant organisms and the urgent need to revisit policies on the use of antibiotics, as well as the reinforcement of antibiotic stewardship.

يمكن للهواتف المحمولة للعاملين في مجال الرعاية الصحية أن تنقل مجموعة من البكتيريا المسببة للأمراض التي تسبب العدوى المكتسبة في المستشفيات إلى المرضى والمجتمع. أجريت هذه الدراسة لتحديد مدى انتشار التلوث البكتيري للهواتف المحمولة للعاملين في مجال الرعاية الصحية، وتقييم أنواع العزلات البكتيرية وأنماط حساسيتها للمضادات الحيوية ومقاومتها والعوامل التي تساهم في التلوث. أُجريت دراسة مقطعية في مركز الهواري للكلى شملت 125 من العاملين في مجال الرعاية الصحية. جُمعت البيانات الديموغرافية والبيانات المتعلقة بتاريخ استخدام المضادات الحيوية وكذلك سلوك التنظيف للهواتف المحمولة وباستخدام استبيان منظم. تم إجراء اختبار الحساسية لمضادات الميكروبات لجميع عينات المسحات من الهواتف المحمولةالتي تم جمعها. تحليل البيانات باستخدام الإصدار 28 من برنامج SPSS. تم الكشف عن معدلات انتشار الكائنات الدقيقة المقاومة للمضادات الحيوية مع الأنماط المقابلة لقابلية التعرض للمضادات الحيوية. تم عرض النتائج باستخدام الجداول للتوضيح. كان الانتشار الإجمالي للتلوث بالهاتف المحمول 84% من العينات الممسوحة. كانت أكثر العزلات البكتيرية شيوعًا هي الزائفة الزنجارية الزنجارية 21.6% تليها الإشريكية القولونية 20.8%، والمكورات العنقودية فوق الجلدية 16.8%، والكلبسيلا الرئوية 14.4%، والمكورات العنقودية الذهبية 6.4%، والمطثية العنقودية 4%، والمطثية العنقودية الذهبية 4%. كانت معظم العزلات حساسة لليفوفلوكساسين (98.1%) وسيبروفلوكساسين (88.6%) وسيفترياكسون (84.8%). أظهر فانكومايسين فعالية محدودة ضد المكورات العنقودية الذهبية على وجه التحديد مع قابلية 13% فقط. كانت 86.7% و71.2% من العزلات البكتيرية مقاومة للإريثروميسين والكليندامايسين على التوالي. لم يتم العثور على أي علاقة ذات دلالة إحصائية بين التلوث بالهاتف المحمول ومتغيرات مختلفة للمشاركين مثل الجنس والعمر والمهنة واستخدام الهاتف المحمول وممارسات النظافة الصحية. كان معدل الانتشار العام للبكتيريا المقاومة للأدوية المتعددة 80%. تشير هذه الدراسة إلى الدور المخيف الذي تلعبه الهواتف المحمولة في نشر الكائنات الحية المقاومة للأدوية المتعددة والحاجة الملحة لإعادة النظر في السياسات المتعلقة باستخدام المضادات الحيوية، فضلاً عن تعزيز الإشراف على المضادات الحيوية

References

Tusabe F, Kesande M, Amir A, Iannone O, Ayebare RR, Nanyondo J. Bacterial contamination of healthcare worker’s mobile phones: a case study at two referral hospitals in Uganda. Global security: health, science and policy 2022; 7: 1–6.

Dhayhi N, Kameli N, Salawi M, Shajri A, Basode VK, Algaissi A, Alamer E, Darraj M, Khalid Shrwani K, Alhazmi AH. Bacterial Contamination of Mobile Phones Used by Healthcare Workers in Critical Care Units: A Cross-Sectional Study from Saudi Arabia. Microorganisms 2023; 11:1986-1997.

Misgana GM, Abdissa K, Abebe G. Bacterial contamination of mobile phones of healthcare workers at Jimma University Specialized Hospital, Jimma, South West Ethiopia. Int J Infect Control 2015; 11(1): 1-8.

Zenbaba D, Sahiledengle B, Beressa G, Desta F, Teferu Z, Nugusu F, Atlaw D, Shiferaw Z, Gezahegn B, Mamo A, Desalegn T, Negash W, Negash G, Mama M, Nigussie E, Chattu VK. Bacterial contamination of healthcare workers’ mobile phones in Africa: a systematic review and meta-analysis. Tropical Medicine and Health 2023; 51:55.

Halwani M, Hussein E, Al-Hawarri H, Alghamdi H, Alghamdi H, Alghamdi A, Alzahrani A, Alghamdi E, Alghamdi R, Alowaydi L, Alghamdi L, Timsah A, Alzahrani K, Zaytoun S. Bacterial Contamination of Healthcare Providers’ Mobile Phones: Potential Risk of Transmission. American Journal of Epidemiology and Infectious Disease 2021; 9: 4-10.

Mohamedin A, Elsayed A, Nashnoush HA. Bacterial Contamination of Mobile Phones Healthcare versus Non-Healthcare Workers at Mansoura City, Egypt. J. Plant Prot. and Path., Mansoura Univ. 2019; 10: 101 – 109.

Siddiqui S, Jamal H, Kotgire S, Afreen U. Bacterial contamination of mobile phones of healthcare workers at a tertiary care hospital. Indian Journal of Microbiology Research 2018; 5:460-465.

Edrees WH, Al-Awar MS. Bacterial contamination of mobile phones of medical laboratory workers at Sana’a city, Yemen and their antimicrobial susceptibility. Journal of Pharmacy & Pharmacognosy Research 2020; 8 (6): 591-599.

Sedighi I, Alikhani MY, Ramezani S, Nazari M, Nejad ASM. Bacterial Contamination of Mobile Phones of Health Care Providers in a Teaching Hospital in Hamadan Province, Iran. Arch Clin Infect Dis. 2015; 10(2): e22104.

Mushabati NA, Samutela MT, Yamba K, Ngulube J, Nakazwe R, Nkhoma P, Kalonda A. Bacterial contamination of mobile phones of healthcare workers at the University Teaching Hospital, Lusaka, Zambia. Infection Prevention in Practice 2021; 3: 100126.

El Mouahid S, Echchakery M, Tounsi A, Boussaa S. Prevalence and inherent factors in the bacterial contamination of the mobile phones of health workers: Literature review. Microbes and Infectious Diseases 2024; DOI: 10.21608/mid.2024.262303.1756.

Tannhauser R, Nickel O, Lindner M, Bethge A, Wolf J, Borte S, Christoph Lubbert C. Bacterial contamination of the smartphones of healthcare workers in a German tertiary-care hospital before and during the COVID-19 pandemic. American Journal of Infection Control 2022; 50: 414 −419.

Maurici M, Pica F , D’Alò GL, Modica DC, Distefano A, Gorjao M, Simonelli MS, Livio Serafinelli L, De Filippis P. Bacterial Contamination of Healthcare Students’ Mobile Phones: Impact of Specific Absorption Rate (SAR), Users’ Demographics and Device Characteristics on Bacterial Load. Life 2023; 13: 1349- 1363.

Bodena D, Teklemariam Z, Balakrishnan S, Tesfa T. Bacterial contamination of mobile phones of health professionals in Eastern Ethiopia: antimicrobial susceptibility and associated factors. . Tropical Medicine and Health 2019; 47:15.

Smith AJ, Johnson D, Brown C. Occupational differences in mobile phone hygiene practices among healthcare workers. J Environ Health. 2021;83(2):16-21.

Kiedrowski BC, Perisetti A, Goyal H. Mobile phone disinfection: Effectiveness and clinical relevance. Am J Infect Control. 2020;48(5):555-7.

Byrd JK, Beers RA, Brady KM. Mobile phone usage and hygiene among healthcare professionals. Am J Infect Control. 2019;47(8):931-6.

Choi J, Kim S, Lee H. The impact of mobile device hygiene education on healthcare workers' compliance with infection control protocols. Infect Control Hosp Epidemiol. 2022;43(3):345-50.

Otter JA, Yezli S, French GL . The role of contaminated surfaces in the transmission of nosocomial pathogens: A systematic review of the literature. BMC Infect Dis. 2013;13:271.

Karpanen TJ, Aitken C, Cookson BD. Mobile phones: A potential vector for infection. J Hosp Infect. 2008;68(3):244-9.

Mazzola PG, De Rosa FG, De Santis R, et al. Antimicrobial susceptibility patterns among Staphylococcus aureus isolated from healthcare workers’ personal items: A systematic review and meta-analysis. Infect Drug Resist. 2022;15:1327-40.

Kaur R, Singh A, Kumar S. Global trends in antimicrobial resistance among Pseudomonas aeruginosa: A systematic review and meta-analysis. Antimicrob Resist Infect Control. 2022;11(1):45.

Kuehn BM. Pseudomonas aeruginosa: A persistent threat in healthcare settings. JAMA 2020;324(12):1209-10.

Elhassan AME, Ali SMO, Ahmed MAE, Antibiotic susceptibility pattern among Pseudomonas aeruginosa isolated from various sources including mobile phones in Khartoum State hospitals: A cross-sectional study.BMC Microbiol.. 2021;21(1):45.

Khan AU, Khan M, Zafar A. Antibiotic susceptibility pattern among Escherichia coli isolated from mobile phone surfaces: Implications for public health safety in Pakistan’s hospitals.BMC Infect Dis.. 2022;22(1):123.

Alzahrani A. Alshammari T, Alhussain H, Alharbi A, & Alotaibi M. Multidrug-resistant Pseudomonas aeruginosa: An emerging threat among healthcare workers’ mobile devices in Saudi Arabia.BMC Infect Dis.. 2021;21(1):123.

Laxminarayan R, Duse A, Wattal C., Zaidi A K M., Wertheim H FL., & Sumpradit N. (2013). Antibiotic resistance: A global crisis. The Lancet Infectious Diseases, 13(12), 1057-1098.

Ventola CL.The antibiotic resistance crisis: Part 1: Causes and threats.P&T.; Print..

O’Neill J., editor.Tackling drug-resistant infections globally: Final report and recommendations.;2016 [Internet]. Web.

Johnson M., Patel S., Wong T.Emerging Resistance Patterns in Staphylococcus aureus: A Clinical Perspective.” Clin Microbiol Rev.;32(3) e00045-18.Print..

Lee H., Kim Y., Park JH.Resistance Trends Among Macrolides and Lincosamides: A Systematic Review.Infect Control Hosp Epidemiol.;42(6)678-685.Print.

Jones RN, Roberts RJ. Global trends in antibiotic resistance among common bacterial pathogens. J Glob Infect Dis. 2019;11(1):1-6.

Peterson E, Kaur P. Antibiotic resistance mechanisms in bacteria: relationships between resistance determinants of antibiotic producers, environmental bacteria, and clinical pathogens. Front Microbiol. 2018;9:2928.