Bacterial Contamination of Mobile Phones used by Healthcare Workers: A Cross-Sectional Microbiological Study

Abstract

Mobile phones are widely used tools in healthcare but can also function as fomites in clinical environments. This cross-sectional study evaluated bacterial contamination, antimicrobial resistance, and behavioral factors linked to contamination on mobile phones used by healthcare workers (HCWs) at a tertiary-care hospital. Two hundred phones from the Intensive Care Unit (ICU), medical and surgical units, and Outpatient Department (OPD) were sampled. Swab isolates were cultured, biochemically identified, evaluated for antimicrobial susceptibility using disk diffusion, and selectively examined by polymerase chain reaction (PCR) targeting mecA, blaCTX-M, blaTEM, blaSHV, blaOXA-23-like, and blaNDM. Of 200 phones, 174 (87.0%) yielded bacterial growth; 18 (10.3%) positive phones were polymicrobial, yielding 192 isolates. Coagulase-negative staphylococci (44.8%) predominated, followed by Staphylococcus aureus (20.3%), Escherichia coli (9.4%), Klebsiella pneumoniae (7.3%), Pseudomonas aeruginosa (6.3%), and Acinetobacter baumannii (4.2%). Thirteen of 39 S. aureus isolates were phenotypically methicillin resistant, and mecA was detected in 12/13 (92.3%). Among Enterobacterales, 13/32 (40.6%) were ESBL-positive by the double-disk synergy test; four additional DDST-positive non-fermenting isolates were treated as exploratory. blaCTX-M was the most frequently detected targeted ESBL gene among the 17 DDST-positive gram-negative isolates (82.4%), and blaOXA-23-like was detected in all three meropenem-non-susceptible A. baumannii isolates. In the adjusted behavioral model, never cleaning the phone (AOR 4.6, 95% CI 1.5-13.9) and phone use during patient care (AOR 3.0, 95% CI 1.2-7.4) remained statistically significant; phone-case use showed a borderline association (AOR 2.5, 95% CI 1.0-6.4). HCW mobile phones were commonly contaminated and harbored clinically important resistant organisms. The findings support evidence-based phone-hygiene guidance and prospective evaluation of standardized decontamination practices.