Infection risks spur physicians' inventions

Interest in cutting hospital-acquired infection rates has added to the growth of antimicrobial products in the health care market.

By Pamela Lewis Dolan — Posted June 7, 2010

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For internist Richard Ma, MD, a hospitalist at Saints Memorial Medical Center in Lowell, Mass., the fight against hospital-acquired infections begins with the stethoscope. For Blaine Warkentine, MD, a Philadelphia-based orthopedist and physician entrepreneur, it starts with the smartphone.

Both physicians have developed tools they say help stop the spread of germs and the growth of bacteria on these two common devices. Dr. Ma invented sterile slip-on covers for stethoscopes. Dr. Warkentine created an antimicrobial cover for smartphones.

For years, studies have looked at the different ways infection can be transmitted from unexpected places. The American Medical Association House of Delegates, at its Annual Meeting in June, is scheduled to hear a Board of Trustees report summarizing much of that research.

Dr. Ma said he expects an interest in his invention -- and antimicrobial products in general -- not only because of research on how infections are passed through everyday items, but also because of Medicare rules put in place in 2008 that can cut reimbursement to hospitals for errors and adverse outcomes termed "never events," which include hospital-acquired infections.

"A lot of changes in medicine, unfortunately, are money driven," Dr. Ma. said "Hospitals are much more forcing nurses and physicians to adhere to cleaning the stethoscope in between patients, washing hands and things like that because of the problems with nosocomial infections. But more because they are going to get penalized because of Medicare rules."

Stethoscope cleanliness was emphasized in medical school, Dr. Ma said. But he said once he was in the real world practicing medicine he, like many of his colleagues, often forgot to sanitize his stethoscope after each use.

A 2009 study from the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School found one of three stethoscopes used by emergency department personnel carried methicillin-resistant Staphylococcus aureus. The longer it had been since the stethoscope was cleaned, the more likely it carried the MRSA virus.

Aware of infection risks, Dr. Ma had been using latex gloves as a cover for the diaphragm of the stethoscope, but realized that because of the design of the boxes the gloves came in, he was likely spreading more germs by doing this. Doctors commonly grab, or at least touch, four or five gloves trying to retrieve just one or two from a box, he said. And they often touch them with nonsterile hands.

After spending four years and $100,000 experimenting with several prototypes, Dr. Ma designed a sterile slip-on stethoscope cover that is disposable and can be produced for pennies. The product is in production.

Dr. Ma said he intends to first deploy the cover in his hospital's precaution room where patients with MRSA are placed in isolation. He also plans to send samples of the covers to other Massachusetts hospitals. Eventually, he said, he would like to work with a distributor to sell the covers.

Cell phones as carriers

Dr. Warkentine said he was busy promoting the use of mobile phone applications for physicians when it occurred to him that the cell phones he was promoting could be a problem.

Several studies have found cell phones to be an active breeding ground for bacteria, even worse than toilet seats. For a study published in the March 2009 Annals of Clinical Microbiology and Antimicrobials, researchers took samples from 200 cell phones belonging to health care workers. These samples, along with samples from the workers' hands, were tested for bacterial growth. Evidence of bacterial contamination was found on 95% of the cell phones; 38% of the hands showed strains of methicillin-resistant bacteria.

Instead of discouraging cell phone use among physicians, Dr. Warkentine set out to design a cover that would help kill the bacteria the devices come into contact with. He designed an iPhone case made partially of silver, which has the natural ability to kill bacteria. He extended the line of cases to include the iPad.

Dr. Warkentine markets these products through RidRx, a company he launched devoted to antimicrobial products. He has other products in development, including a lab coat that, when washed in bleach, maintains the chlorine until the next wash, continually working to kill bacteria.

The creations by Drs. Warkentine and Ma are just two examples of bacteria-fighting products making their way to the medical market.

Aniruddh Menon, an industry analyst at Frost & Sullivan, said because many hospital-based efforts, including the use of personal protective equipment like gloves and masks, require the willingness of people to use them, they are not guaranteed solutions. This has contributed to a boom in the market for health care products aimed at fighting bacteria.

Menon authored a report that found 90% of the growth of the antimicrobial products in the health care market is attributed to hospital-acquired infections. By 2015, the world market for antimicrobial plastics in health care is expected to reach 330 million pounds.

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External links

"Are we aware how contaminated our mobile phones with nosocomial pathogens?" abstract, Annals of Clinical Microbiology and Antimicrobials, March 2009 (link)

"Prevalence of Methicillin-Resistant Staphylococcus aureus on the Stethoscopes of Emergency Medical Services Providers," abstract, Prehospital Emergency Care, January 2009 (link)

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