title: Extended-spectrum β-lactamase-producing Enterobacteriaceae in cell phones of health care workers from Peruvian pediatric and neonatal intensive care units.
abstract: Health care workers (HCWs) use their mobile phones during working hours or medical care. There is evidence that the instruments are colonized with pathogenic microorganisms. Here, we describe levels of Enterobacteriaceae contamination (EC) in cell phones and the risk factors associated with EC in Peruvian intensive care units (ICUs).
  
  
  
  This was a 5-month cohort study among 114 HCWs of 3 pediatric and 2 neonatology ICUs from 3 Peruvian hospitals. A baseline survey collected data on risk factors associated with EC. Swabs were collected from HCWs' phones every other week.
  
  
  
  Three-quarters of HCWs never decontaminated their phones, and 47% reported using the phones in the ICU >5 times while working. EC was frequent across samplings and sites and was substantially higher in subjects with longer follow-up. Potential risk factors identified did not have strong associations with positive samples (relative risk, 0.7-1.5), regardless of significance. Half of the phones were colonized with an Enterobacteriaceae at least once during the 4 samplings attained on average during the study period. Half of the isolates were multidrug resistant (MDR), and 33% were extended-spectrum β-lactamase producers.
  
  
  
  EC on HCWs' phones was frequent and apparently randomly distributed through the hospitals without clear clustering or strongly associated risk factors for having a positive sample. Based on the level of EC, phones may be considered as potential bacterial reservoirs of MDR and ESBL bacteria.
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru; U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru. Electronic address: steev.loyola@gmail.com.
authors.forename: Steev
authors.initials: S
authors.lastname: Loyola
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Luz R
authors.initials: LR
authors.lastname: Gutierrez
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Gertrudis
authors.initials: G
authors.lastname: Horna
authors.affiliation: U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru.
authors.forename: Kyle
authors.initials: K
authors.lastname: Petersen
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Juan
authors.initials: J
authors.lastname: Agapito
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru; Universidad Católica Santo Toribio de Mogrovejo, Chiclayo, Peru.
authors.forename: Jorge
authors.initials: J
authors.lastname: Osada
authors.affiliation: U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru.
authors.forename: Paul
authors.initials: P
authors.lastname: Rios
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru; U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru.
authors.forename: Andres G
authors.initials: AG
authors.lastname: Lescano
authors.affiliation: Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Jesus
authors.initials: J
authors.lastname: Tamariz
mesh_terms: D040421:Cell Phone; D015331:Cohort Studies; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000302:isolation & purification*; D050456:Fomites / Q000382:microbiology*; D006282:Health Personnel; D006776:Hospitals, Pediatric; D006801:Humans; D015278:Intensive Care Units, Pediatric; D010568:Peru; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases
keywords: Cell phones; Enterobacteriaceae; Health personnel; Infectious disease transmission, professional-to-patient