Contamination of physicians' stethoscopes who works in hospital areas: medical-forensic implications

摘要

Objectives: Analyze quantitatively and qualitatively the microbiological contaminations instethoscopes’ diaphragms used by physicians, verify the efficacy of antisepsis performed with 70% ethanol andstimulates medical discussion of related legal implications. Methods: Using the method in print, cultures of 70private stethoscopes of randomly selected physicians in Belo Horizonte, Minas Gerais - Brazil, hospital areawere taken, between March and November 2010. The cultures were made on Müller-Hinton and Sabouraud agarplates and were incubated for appropriate development of bacteria and fungi. This procedure was performedtwice in each stethoscope, one before and another after 70% ethanol cleaning. For identification andclassification of each isolated colony were performed standard tests and, for bacteria, also the antibiogram.Results: It was not found any fungi colonies in the samples. Before the antisepsis with 70% ethanol, it has beenisolated 182 different types of bacterial colonies. 98,6% (69), of the 70 surveyed stethoscopes, werecontaminated at least with one specie. Identified species included coagulase negative Staphylococcus (64,3%),being 41% Amoxicillin resistant; Staphylococcus aureus (4,4%), 50% Chloramphenical resistant;Enterobacteriaceae (2,1%), 100% Ceftazidime resistant, and gram positive bacillus. After the antisepsis, it wasisolated 62 distinct types of colonies, that means 66,1% less contamination than found before, and 22 samples(34,3%) did not have any kind of bacterial growth. Also, it has been found coagulase negative Staphylococcus(62,9%) and the antibiogram indicated that 30,8% of these were Amoxicillin resistant. Conclusions:Stethoscopes can be vectors in the dissemination of nosocomial infections, duo to high incidence of bacteria onthe diaphragm. Frequently, antibiotic resistant bacteria were isolated. It can result in medical-forensicirreversible implications for the physician and his patient’s health. It is clear that the adherence to regularstethoscope disinfection practices is fundamental, and the 70% ethanol proved to be a powerful alternative.Key words: forensic medicine, stethoscopes, contamination, bacteria, Brazil.