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Welcome to the wards: Pilot study on microbial contamination of medical students during initial clinical rotations

Background: Pathogenic bacteria can colonise the hands, medical equipment, and personal belongings of healthcare workers (HCW) exposed to clinical environments. Healthcare-associated infections (HAI) arising from the transmission of these pathogens to patients causes morbidity, mortality, and an economic burden. Despite widespread healthcare worker education and policy change, the incidence of HAI remains high in Australia.

Aim: To identify potentially pathogenic bacterial contamination of clinically unexposed medical students’ hands and items upon entry into the clinical environment and subsequent design of a definitive study.

Materials and methods: A pilot prospective cohort study was performed at a large tertiary hospital in Melbourne, Victoria. Eight medical students had two- to six-week samples taken from their dominant hand, mobile phones, and stethoscopes in the first six months of entering the clinical environment.

Results: Pathogenic bacteria were detected throughout the six-month testing period on five of the eight students’ hands, mobile phones, or stethoscopes. Pathogenic bacteria grown included methicillin-sensitive Staphylococcus aureus, Enterococcus faecalis, and Gram-negative pathogens, such as Serratia marcescens, Pseudomonas spp. and Acinetobacter baumanii. No multi-resistant organisms were detected. Low decontamination rates of items, universal use of phones while on the toilet, and recent hand hygiene credentialing were reported by participants.

Conclusion: Colonisation by nosocomial pathogens on medical students’ hands, mobile phones, and stethoscopes was identified during the first six months of clinical study. Further research to characterise bacterial contamination of new HCW, risk factors, and strategies to improve infection control practices has the potential to reduce HAI.

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