EMS Providers Urged to Clean Stethoscopes to Prevent MRSA Transmission

Emergency medical services providers should clean their stethoscopes more frequently to prevent transmission of methicillin-resistant Staphylococcus aureus (MRSA), urges Dr. Mark Merlin, chair of the Mobile Intensive Care Unit Advisory Committee for the New Jersey Department of Health and Senior Services.

One in three stethoscopes from a sampling of emergency medical services (EMS) providers from New Jersey tested positive for MRSA in a recent UMDNJ study led by Merlin, who is an assistant professor of emergency medicine and pediatrics at the UMDNJ-Robert Wood Johnson Medical School.

“There’s a simple solution for this potentially serious problem,” Merlin said. “Provide isopropyl alcohol wipes at hospital emergency room entrances so EMS professionals can clean their stethoscopes regularly.”

MRSA infections have been on the rise within the last decade and many blame hospitals, Merlin said. “But it may be acquired before hospitalization,” he added.

In the study, researchers swabbed 50 stethoscopes used by independent emergency medical service providers -- including EMTs, nurses, and paramedics – who visited a New Jersey hospital’s emergency department with patients during a 24-hour period. Cultures were incubated for 72 hours and then analyzed by two emergency physicians and one microbiologist from UMDNJ.

“Of the 50 stethoscopes, 16 had MRSA colonization and the same number couldn’t remember the last time their stethoscopes were cleaned,” said Merlin, who also is medical director of Emergency Medical Services (EMS) at Robert Wood Johnson University Hospital.

Stethoscopes are known potential transmitters for MRSA. Still, Merlin was surprised by this study’s results. “I thought maybe one percent of stethoscopes would be infected,” he said.

Researchers suspect the length of time between stethoscope cleanings may increase the possibility of transmission. According to the study, the median reported length of time between cleanings was one to seven days. “The longer period of time between cleanings, the more likely it is you have this bacteria,” Merlin said.

Additional study details are available in “Prevalence of Methicillin-Resistant Staphylococcus aureus on the Stethoscopes of Emergency Medical Services Providers,” an article appearing in the current issue of Prehospital Emergency Care.

The research team is following up this study with two others. In one study, stethoscopes with MRSA are inoculated and researchers will try to determine the best cleaning method -- soap and water vs. isopropyl alcohol. The second study examines how long MRSA can survive on the surface of the stethoscope.