Point-prevalence of contamination of healthcare workers' stethoscopes with vancomycin-resistant enterococci at two teaching hospitals in Cleveland, Ohio.

To the Editor: Vancomycin-resistant enterococci (VRE) have been isolated from a variety of surfaces in the hospital environment, including gowns, call buttons, bed rails, blood pressure cuffs, and stethoscopes.Contaminated electronic rectal thermometers and ear-probe thermometers have been implicated as possible sources for transmission of VRE. High rates of contamination of stethoscopes with bacteria, particularly coagulase-negative staphylococci and Staphylococcus aureus, have been documented. We examined the point-prevalence of contamination of stethoscope diaphragms with VRE at two teaching hospitals in Cleveland, Ohio, with high rates of endemic VRE stool colonization. We hypothesized that contamination of healthcare workers' stethoscopes might occur after contact with as-yet-unidentified VREcolonized patients. For one of the hospitals, we also examined the point-prevalence of contamination of shared blood pressure cuffs and electronic ear-probe thermometers. We performed cultures on 71 healthcare workers' stethoscopes (physicians, nurses, or medical students) at the two teaching hospitals on a single day. Both hospitals perform active surveillance for VRE stool colonization and isolate patients with known colonization. Eleven stethoscopes that were dedicated to VRE-colonized patients' rooms also had cultures obtained. Premoistened cotton-tipped swabs were applied to the stethoscope diaphragm for at least 5 seconds and immediately plated on Enterococcosel (Becton-Dickinson, Cockeysville, MD) agar containing 6 ug/mL of vancomycin. These plates were incubated at 37°C and read after 72 hours. All colonies present were further identified by the automated Microscan (DadeBehring, Sacramento, CA) system. At one of the hospitals on a different day, 16 ear-probe thermometers and 13 blood pressure cuffs were assessed in a similar fashion.