title: Prevalence of methicillin-resistant Staphylococcus aureus on the stethoscopes of emergency medical services providers.
abstract: OBJECTIVE
  The investigation seeks to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) on the stethoscopes of emergency medical services (EMS) providers. While stethoscopes are known fomites for MRSA, the prevalence of MRSA in the prehospital setting is not well documented in the literature.
  
  
  METHODS
  This was a prospective, observational cohort study of 50 stethoscopes provided by consecutive, consenting EMS providers at our academic emergency department (ED). Stethoscopes were swabbed with saline culture applicators and samples were cultured on a commercial MRSA test kit containing mannitol salt agar with oxacillin. After 72 hours of incubation at 37 degrees C, two emergency physicians and one microbiologist analyzed the plates independently. MRSA colonization was recorded as positive if all three reviewers agreed that colonization had occurred.
  
  
  RESULTS
  Of 50 stethoscopes, 16 had MRSA colonization, and 16 (32%) EMS professionals had no recollection of when their stethoscopes had been cleaned last. Reported length of time since last cleaning was grouped into six categories: one to seven days, eight to 14 days, 15 to 30 days, 31 to 180 days, 181 days to 365 days, and unknown. The median time frame reported since the last cleaning was one to seven days. In the model, an increase from one time category to the next increased the odds of MRSA colonization by 1.86 (odds ratio = 1.86, p = 0.038).
  
  
  CONCLUSIONS
  In this ED setting, MRSA was found on approximately one in three stethoscopes of EMS professionals. A longer length of time since the last stethoscope cleaning increased the odds of MRSA colonization.
authors.affiliation: Department of Emergency Medicine, Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901, USA. merlinma@umdnj.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Merlin
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Wong
authors.forename: Peter W
authors.initials: PW
authors.lastname: Pryor
authors.forename: Kevin
authors.initials: K
authors.lastname: Rynn
authors.forename: Andreia
authors.initials: A
authors.lastname: Marques-Baptista
authors.forename: Rachael
authors.initials: R
authors.lastname: Perritt
authors.forename: Catherine G
authors.initials: CG
authors.lastname: Stanescu
authors.forename: Timothy
authors.initials: T
authors.lastname: Fallon
mesh_terms: D015331:Cohort Studies; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000209:etiology; D003666:Decontamination / Q000706:statistics & numerical data; D004634:Emergency Medical Technicians; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009515:New Jersey / Q000453:epidemiology; D015995:Prevalence; D019023:Stethoscopes / Q000382:microbiology*