Decontamination of mobile phones and electronic devices for health care professionals using a chlorhexidine/carbomer 940® gel

Abstract

Though they reduce microorganism growth, current hospital disinfectants also damage many of today’s modern electronic devices such as tablets and smartphones. Herein, the efficacy of a new chlorhexidine digluconate gel (CDG) was tested as a disinfectant for mobile and electronic devices in a clinical environment. Specifically, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus were used to infect the screen of eight smartphones. The CDG was prepared at concentrations of 2%, 4% and 6%, and tested on paper disks infected with these bacteria before being tested on the smartphones. The devices were disinfected with the CDG gel (4%) at two times: immediately and after 5 min of the bacterial contamination. In all cases, the CDG gel eliminated 100% of gram-positive and gram-negative microorganisms compared to the control (without any agent). In addition, the gel did not damage the smartphones. Therefore, our study suggests that the CDG gel may be applied to disinfect a wide range of electronic devices for health care professionals in the hospital environment.

Graphical abstract

Keywords

smartphones / disinfection / clinical environment / chlorhexidine / bacteria

References

[1] Madden G R, Weinstein R A, Sifri C D. Diagnostic stewardship for healthcare-associated infections: Opportunities and challenges to safely reduce test use. Infection Control and Hospital Epidemiology, 2018, 39(2): 214–218

[2] Grant M C, Yang D, Wu C L, Makary M A, Wick E C. Impact of enhanced recovery after surgery and fast track surgery pathways on healthcare-associated infections. Results from a systematic review and meta-analysis. Annals of Surgery, 2017, 265(1): 68–79

[3] Jasovský D, Littmann J, Zorzet A, Cars O. Antimicrobial resistance-a threat to the world’s sustainable development. Upsala Journal of Medical Sciences, 2016, 121(3): 159–164

[4] Lemmen S W, Häfner H, Zolldann D, Stanzel S, Lütticken R. Distribution of multi-resistant Gram-negative versus Gram-positive bacteria in the hospital inanimate environment. Journal of Hospital Infection, 2004, 56(3): 191–197

[5] Deak D, Outterson K, Powers J H, Kesselheim A S. Progress in the fight against multidrug-resistant bacteria? A review of U.S. food and drug administration—approved antibiotics, 2010–2015. Annals of Internal Medicine, 2016, 165(5): 363–372

[6] Kramer A, Schwebke I, Kampf G. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infectious Diseases, 2006, 6(1): 130

[7] Hammon M, Kunz B, Dinzl V, Kammerer F J, Schwab S A, Bogdan C, Uder M, Schlechtweg P M. Practicability of hygienic wrapping of touchscreen operated mobile devices in a clinical setting. PLoS One, 2014, 9(9): e106445

[8] Zeglin L H. Stream microbial diversity in response to environmental changes: review and synthesis of existing research. Frontiers in Microbiology, 2015, 6(454): 454

[9] Zakai S, Mashat A, Abumohssin A, Samarkandi A, Almaghrabi B, Barradah H, Jiman-Fatani A. Bacterial contamination of cell phones of medical students at King Abdulaziz University, Jeddah, Saudi Arabia. Journal of Microscopy and Ultrastructure, 2016, 4(3): 143–146

[10] Sorensen J A, Doherty F M, Newman M G, Flemmig T F. Gingival enhancement in fixed prosthodontics. Part I: Clinical findings. Journal of Prosthetic Dentistry, 1991, 65(1): 100–107

[11] Jones C G. Chlorhexidine: Is it still the gold standard? Periodontology 2000, 1997, 15(1): 55–62

[12] Supranoto S C, Slot D E, Addy M, Van der Weijden G A. The effect of chlorhexidine dentifrice or gel versus chlorhexidine mouthwash on plaque, gingivitis, bleeding and tooth discoloration: A systematic review. International Journal of Dental Hygiene, 2015, 13(2): 83–92

[13] Vitkov L, Hermann A, Krautgartner W D, Herrmann M, Fuchs K, Klappacher M, Hannig M. Chlorhexidine-induced ultrastructural alterations in oral biofilm. Microscopy Research and Technique, 2005, 68(2): 85–89

[14] Ferraz C C R, Gomes B P F A, Zaia A A, Teixeira F B, Souza-Filho F J. Comparative study of the antimicrobial efficacy of chlorhexidine gel, chlorhexidine solution and sodium hypochlorite as endodontic irrigants. Brazilian Dental Journal, 2007, 18(4): 294–298

[15] Kim J Y, Song J Y, Lee E J, Park S K. Rheological properties and microstructures of Carbopol gel network system. Colloid & Polymer Science, 2003, 281(7): 614–623

[16] Zheng Y, Ouyang W Q, Wei Y P, Syed S F, Hao C S, Wang B Z, Shang Y H. Effects of Carbopol^® 934 proportion on nanoemulsion gel for topical and transdermal drug delivery: A skin permeation study. International Journal of Nanomedicine, 2016, 11: 5971–5987

[17] Mathew J I, Cadnum J L, Sankar T, Jencson A L, Kundrapu S, Donskey C J. Evaluation of an enclosed ultraviolet-C radiation device for decontamination of mobile handheld devices. American Journal of Infection Control, 2016, 44(6): 724–726

[18] Gashaw M, Abtew D, Addis Z. Prevalence and antimicrobial susceptibility pattern of bacteria isolated from mobile phones of health care professionals working in gondar town health centers. International Scholarly Research Notices, 2014, 2014: 1–6

[19] Shakir I A, Patel N H, Chamberland R R, Kaar S G. Investigation of cell phones as a potential source of bacterial contamination in the operating room. Journal of Bone and Joint Surgery, 2015, 97(3): 225–231

[20] A-sasutjarit R, Sirivat A, Vayumhasuwan P. Viscoelastic properties of Carbopol 940 gels and their relationships to piroxicam diffusion coefficients in gel bases. Pharmaceutical Research, 2005, 22(12): 2134–2140

[21] Jana S, Manna S, Nayak A K, Sen K K, Basu S K. Carbopol gel containing chitosan-egg albumin nanoparticles for transdermal aceclofenac delivery. Colloids and Surfaces B: Biointerfaces, 2014, 114: 36–44

[22] Barry B W, Meyer M C. The rheological properties of carbopol gels. I. Continuous shear and creep properties of carbopol gels. International Journal of Pharmaceutics, 1979, 2(1): 1–25

[23] Santos I R M, Moreira A C A, Costa M G C, Barbosa M C. Effect of 0.12% chlorhexidine in reducing microorganisms found in aerosol used for dental prophylaxis of patients submitted to fixed orthodontic treatment. Dental Press Journal of Orthodontics, 2014, 19(3): 95–101

[24] McDonnell G, Russell A D. Antiseptics and disinfectants: activity, action, and resistance. Clinical Microbiology Reviews, 1999, 12(1): 147–179

[25] Perioli L, Ambrogi V, Angelici F, Ricci M, Giovagnoli S, Capuccella M, Rossi C. Development of mucoadhesive patches for buccal administration of ibuprofen. Journal of Controlled Release, 2004, 99(1): 73–82

[26] Velasquez Reyes D C, Bloomer M, Morphet J. Prevention of central venous line associated bloodstream infections in adult intensive care units: A systematic review. Intensive & Critical Care Nursing, 2017, 43: 12–22

Acknowledgements

The authors are very grateful to the team from the bacteriology sector of the Clinical Laboratory of University Hospital of West of Paraná for laboratory evaluation and aid of the application of data collection. Anderson Oliveira Lobo and Fernanda Roberta Marciano would like to thank the National Council for Scientific and Technological Development (CNPq grant numbers: AOL ‒ 303752/2017-3 and FRM ‒ 304133/2017-5), Coordination for the Improvement of Higher Education Personnel (CAPES, grant numbers 88881.120138/2016-01 and 88881.120221/2016-01) and to the Universidade Brasil for scholarships. English language corrections were provided by Ms. Jessica Fitzgerald, a writing consultant for the Chemical Engineering Writing Center at North-eastern University.

This study did not count on funding fomenting agencies. There are no conflicts of interest by the authors.

RIGHTS & PERMISSIONS

2018 Higher Education Press and Springer-Verlag GmbH Germany, part of Springer Nature