NEWS RELEASE UNDER EMBARGO UNTIL FEBRUARY 27, 2014, 12:00 PM CT Accompanying video available at: http://youtu.be/I7glVHaTo2c (Video under embargo until February 27, 2014, 12:00 PM CT) Contact: Rachael Zaleski Elsevier Tel: 215-239-3658 mcpmedia@elsevier.com

Physicians Stethoscopes More Contaminated Than Palms of Their Hands Results of New Study Published in Mayo Clinic Proceedings

A comparative analysis shows that stethoscope diaphragms are more contaminated than the physicians own thenar eminence (group of muscles in the palm of the hand) following a physical examination. Rochester, MN, February 27, 2014 Although healthcare workers hands are the main source of bacterial transmission in hospitals, physicians stethoscopes appear to play a role. To explore this question, investigators at the University of Geneva Hospitals assessed the level of bacterial contamination on physicians hands and stethoscopes following a single physical examination. The study appears in the March issue of Mayo Clinic Proceedings. By considering that stethoscopes are used repeatedly over the course of a day, come directly into contact with patients skin, and may harbor several thousands of bacteria (including MRSA) collected during a previous physical examination, we consider them as potentially significant vectors of transmission, commented lead investigator Didier Pittet, MD, MS, Director of the Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals. From infection control and patient safety perspectives, the stethoscope should be regarded as an extension of the physicians hands and be disinfected after every patient contact. In this study, 71 patients were examined by one of three physicians using sterile gloves and a sterile stethoscope. After they completed the examination, two parts of the stethoscope (the tube and diaphragm) and four regions of the physicians hands (back, fingertips, and thenar and hypothenar eminences) were measured for the total number of bacteria present. The stethoscopes diaphragm was more contaminated than all regions of the physicians hand except the fingertips. Further, the tube of the stethoscope was more heavily contaminated than the back of the physicians hand. Similar results were observed when contamination was due to methicillin-resistant S.aureus (MRSA) after examining MRSA-colonized patients.

This work is the first to compare directly the level of contamination of physicians hands and stethoscopes. Stethoscope contamination is not trivial and is comparable to the contamination of healthcare workers fingertips, the hand region most implicated in microbial cross-transmission. Physicians must be aware of the need to disinfect their stethoscope after each use.

# # # NOTES FOR EDITORS Contamination of Stethoscopes and Physicians Hands After a Physical Examination, by Yves Longtin, MD; Alexis Schneider, MD; Clment Tschopp, MD; Gesule Renzi, MS; Angle Gayet-Ageron, MD, PhD; Jacques Schrenzel, MD; and Didier Pittet, MD, MS (DOI: http://dx.doi.org/10.1016/j.mayocp.2013.11.016). Mayo Clinic Proceedings, Volume 89, Issue 3 (March 2014), published by Elsevier. Full text of the article is available to credentialed journalists upon request. Contact Rachael Zaleski at 215-239-3658 or mcpmedia@elsevier.com to obtain copies. To view an accompanying video presented by Dr. Didier Pittet go to http://youtu.be/I7glVHaTo2c (under embargo until February 27, 2014, 12:00 PM CT). Journalists wishing to interview the authors may contact Dr. Didier Pittet at +41 22 372 9833 or +41 22 372 9828 or via email at Didier.Pittet@hcuge.ch. ABOUT MAYO CLINIC PROCEEDINGS The flagship journal of Mayo and one of the premier peer-reviewed clinical journals in general medicine, Mayo Clinic Proceedings is among the most widely read and highly cited scientific publications for physicians, with a circulation of approximately 125,000. While the Journal is sponsored by Mayo Clinic, it welcomes submissions from authors worldwide, publishing articles that focus on clinical medicine and support the professional and educational needs of its readers. www.mayoclinicproceedings.org ABOUT MAYO CLINIC Mayo Clinic is a nonprofit worldwide leader in medical care, research, and education for people from all walks of life. For more information visit www.mayoclinic.org/about and www.mayoclinic.org/news. ABOUT ELSEVIER Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet (www.thelancet.com) and Cell (www.cell.com), and close to 20,000 book titles, including major reference works from Mosby and Saunders. www.elsevier.com