Mobile devices can be contaminated by viral RNA due to poor adherence to cleaning protocols
[Editor’s Note:] This article was contributed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).
In clinical settings, mobile phones benefit patients by placing useful data and information at the fingertips of health professionals during interactions in the ward, but are doctors and nurses unwittingly exposing vulnerable patients to a potential source of infection just by tapping their touch screen?
Previous studies have already shown that the surfaces of mobile phones harbor nosocomial bacteria, including coliforms, vancomycin-resistant enterococci, Pseudomonas and methicillin-resistant Staphylococcus aureus (MRSA). Now, a study1 by Sylvie Pillet from the Laboratory of Infectious Agents and Hygiene at the University Hospital of Saint-Étienne in France has revealed that mobile devices are often also contaminated by viral RNA.
Pathogens on PhonesUsing various methods of telecommunication is the norm in hospital environments. 99% of the healthcare workers in the study used departmental DECT phones, and 38% used their own personal mobile phone when interacting with patients. The research team sampled the devices used daily by 114 healthcare workers at the University Hospital of Saint-Étienne in Saint-Priest-en-Jarez, France.
Swabs were frozen immediately after collection, and a one-step reverse transcription and quantitative polymerase chain reaction (PCR) was later used to amplify any viral genetic material captured. Specific assays determined the presence of RNA-from potentially epidemic respiratory viruses (influenza A and B, respiratory syncytial virus and human metapneumovirus) to common enteric viruses (rotavirus and norovirus).
Healthcare workers also filled out a detailed questionnaire to enable the team to understand more about when and where each phone was used. Results of the questionnaire and the molecular tests were analyzed using blinding to avoid bias. The findings are published in the May issue of Clinical Microbiology and Infection.
Viral RNA was present on 38.5% of the devices; the most prominent contamination was from rotavirus RNA (39 of 109 devices), with respiratory syncytial virus RNA present on three phones and human metapneumovirus RNA on only one. No viral RNA from norovirus or either of the two influenza viruses was detected.
Results from samples taken from 22 medical students in the department were not included in the results as they did not answer the questionnaire, but the researchers found half of the phones that the students used regularly were contaminated. Seven were positive for rotavirus RNA, while three were found to harbur influenza virus RNA.
The report cautioned that the sample size was small and not sufficient to demonstrate any correlation between the presence of viral RNA and a quantifiable risk of nosocomial transmission of viral infection. This has not been demonstrated by other studies, despite the well-documented persistence of viral RNA on hospital surfaces. Rotavirus RNA, for example, has been shown to remain for several months after the epidemic winter season-and even after surfaces have been cleaned.
The majority of healthcare workers (64%) used their mobile phones during patient care, which was expected. However, it was surprising that 20% of them admitted never carrying out any hand hygiene procedures either before or after using their phone, even though all said they knew phones could harbor pathogens. Many healthcare professionals did not carry out any hand hygiene procedures even if using a mobile phone while making physical contact with patients.
The survey also revealed that cordless hospital phones were cleaned and disinfected less frequently in pediatric departments than on adult wards. A multivariate analysis demonstrated a significant association between the presence of viral RNA and the mobile phones of healthcare workers in the pediatric department. These results should encourage hospitals to remain vigilant in hand hygiene protocols and to institute better protocols for cleaning and disinfecting both mobile and hospital phones.
Evidence showed that antiseptic wipes and hand rubs containing alcohol that are readily available in hospital settings (including the one in the study) can destroy viral RNA on experimentally contaminated hands. Although non-enveloped viruses that are commonly associated with viral gastroenteritis are much more resistant to all disinfectants used routinely in hospitals-even rotavirus and norovirus are susceptible to hydroalcoholic hand rubs.
The fact that rotavirus RNA is found on so many of phones used by health workers in this study underlines that adherence to current policies is poor, a cause for concern in itself. Hand hygiene should be performed just before patient contact, as highly recommended by World Health Organization (WHO) guidelines. Mobile devices can be cleaned with alcohol wipes. This is particularly important in pediatric settings, where viruses circulate quickly with devastating impact.
- S. Pillet; P. Berthelot; A. Gagneux-Brunon; O. Mory, C. Gay; A. Viallon; F. Lucht; B. Pozzetto, E. Botelho. Contamination of healthcare workers’ mobile phones by epidemic viruses. Clinical Microbiology and Infection (CMI). http://dx.doi.org/10.1016/j.cmi.2015.12.008