Extended-Spectrum Beta-Lactamase-Producing Gram-Negative Bacteria on Healthcare Workers’ Mobile Phones: Evidence from Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Abstract

Background: Mobile phones are widely used in hospital settings for different purposes. Mobile phones of healthcare workers (HCWs) could be colonized or harbor extendedspectrum beta-lactamase (ESBL) producing gram-negative bacteria and may act as source of infectious agents. The aim of this study was to determine the rate of extended-spectrum beta-lactamase-producing Gram-negative bacteria on mobile phones of healthcare workers, to assess their antimicrobial susceptibility patterns and associated factors. Methods: A laboratory-based cross-sectional study was conducted involving a total of 572 samples by rubbing swabs of the front screen, back, keypad, and metallic surfaces of mobile phones of healthcare workers using simple random sampling technique. All specimens were screened for ESBL using ESBL CHROME agar and confirmed using double-disk diffusion test (DDDT). Antibiotic susceptibility testing was done by the Kirby-Bauer disk diffusion technique on Mueller-Hinton agar. Data were analyzed using SPSS version 25, odds ratio and p-value was calculated to determine the association among variables. Results: Overall, the number of mobile phones contaminated by gram-negative bacteria was 454 out of 572 (79.4%). Female sex (OR 0.651, p-value=0.039) and service year (OR 0.468, p-value=0.038) of healthcare workers were found to be the most significant factors associated with healthcare professionals' mobile phone and bacterial contamination. Nine percent of the isolates were ESBL-producers. K. pneumoniae (27%) was the dominant ESBLproducing isolate followed by Acinetobacter spp. (14.5%) and E.coli (14.5%). ESBL-producers were highly resistant to ampicillin (95.8%), piperacillin (83.3%), cotrimoxazole (70.8%), and chloramphenicol (54.2%), but highly sensitive to meropenem (87.5%), amikacin (85.4%), and piperacillin-tazobactam (81.2%). Conclusion: ESBL-producing Gram-negative bacteria were isolated from 8.3% of HCWs' mobile phones. As high as 79.4% of the isolates were multidrug resistant. Mobile phones can lead to bacterial cross-contamination and could be a source of nosocomial infections.

Bacterial contamination of Healthcare workers’ mobile phones in Africa: a systematic review and meta-analysis

“…We descriptively explained the antimicrobial susceptibility and multidrug resistance of bacterial isolates using 14 studies [21, 22, 24, 25, 42–46, 53–56, 58]. According to an Ethiopian study, bacterial isolates had a greater rate of resistance to penicillin (84%), ampicillin (81%), and tetracycline (81%).…”

“…Following the exclusion of 844 articles, a total of 87 full-text papers were verified for eligibility using the pre-determined criteria, with 64 articles being excluded. Finally, 23 articles [21][22][23][24][25][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] that satisfied the criteria were included in the meta-analysis (Fig. 1).…”

“…The current meta-analysis used 2,623 mobile phones from healthcare professionals to estimate the pooled proportion of bacterial contamination. In terms of sub-regional distribution, nine studies were from Eastern Africa [22,24,25,42,[44][45][46]58], four studies from Western [21,51,52,55], seven studies from Northern [23,[47][48][49][50]54, 57], one study from Southern [56], and two studies from middle African countries [53,59] (Table 1).…”

“…In low-and middle-income countries' healthcare settings, bacterial contamination rates of mobile phones used by healthcare personnel ranged from 42% to 100%. The most prevalent bacteria isolated were coagulase-negative staphylococci, Escherichia coli, Acinetobacter species, Pseudomonas species, and MRSA bacteria [20][21][22][23][24][25][26]. Several infectious illnesses, including diarrhea, food poisoning, and wound infections, are caused by these bacteria [3,27,28].…”

Bacterial Colonization on Healthcare Workers’ Mobile Phones and Hands in Municipal Hospitals of Chongqing, China: Cross-contamination and Associated Factors

“…Galazzi A et al have reported that the isolation rate of MRSA was up to 17% in ICU [ 26 ]. Another study from Ethiopia showed that Gram-negative bacteria were isolated from 8.3% of HCWs’ mobile phones and 79.4% of the isolates were multidrug resistant [ 31 ]. Antibiotic-resistant bacteria are the most serious health risk for hospitalized patients [ 32 ].…”