Microbial contamination can be defined as the accidental or non-intended introduction of the different types of microbes such as bacteria, yeast, mould, fungi, virus, prions, protozoa or their toxins and by-products. According to the Walia, Manchanda and Narang (2014), the microbes are ubiquitous in nature and hence the risk of microbial contamination is ever-present. It has to be mentioned in this context that the exposure to microorganisms or their byproducts is mostly facilitated by inhalation and contact with the mucous membrane. In everyday life, there can be a variety of transmission points which can lead to microbial contamination based on the different settings. For instance, there can be various different sources of contamination such as utility based contamination, equipment based contamination, facility based contamination, material based contamination and personnel based contamination. On a more elaborative note, it can be stated that germs can be spread via a number of different resources such as contaminated air causing airborne contamination, outer skin of the personnel for contact based contamination, and manufacturing processes which can lead to a variety of different contaminations. According to the Verani, Bigazzi and Carducci (2014), it has to be mentioned that even a sneeze can produce close to 1 million bacteria. With respect to the mechanism of contamination of the different microbes, there are two basic types of contamination. The first type of contamination is the direct contamination, which is facilitated by microbial components and poorly maintained HVAC systems. The second type of contamination is the cross contamination which is the type of contamination that constitutes the majority of microbial spread in the household setting.
Another very important aspect of microbial contamination in the day to day life is through the washrooms. According to the Jeon, Chun and Kim (2013), the infection prevention behaviors instilled in the different populations is limited to covering mouths when coughing or sneezing, hand hygiene and wiping down the germ surfaces such as desks, however the personal hygiene habits have not been able to extend to the washroom even now. The washroom or the toilet seat most evidently can serve as a reservoir of germs or microbes which can cause a variety of different communicable diseases. On a more elaborative note, there is a mircobiom residing in the toilet seat and every time a particular individual is flushing the toilet with the lid open the bacteria sprays into the air contaminating it significantly. As per the article by the Gov.uk (2018), one of the most dangerous infectious pathogen found in the toilet seat had been Clostridium difficile, which is a notorious bacteria responsible for causing watery diarrhea, ever, nausea, and abdominal pain, the researchers are of the opinion that this particular pathogen is able to be spewed up up to 10 inches above the toilet seats and as a result can contaminate the air, the other nearby surfaces and the skin of the occupant using the toilet seat. The washroom germs are not only contaminating the skin of the occupant it can also transfer to everything the person touches including washroom supplies, materials, and even the doors and doorknobs (Pal et al. 2013).
Another very common of the present day tech savvy generation is to take their smart devices such as the smart phones, ipads, tablets to the washroom, and hence the contaminated air, skin and surfaces of the washroom can then contaminate the touch screen device. These smartphones or tablets are carried by the user for the entire day and if the touch-screen devices are not cleaned properly or sterilized it can lead to various infectious diseases by contaminating everything it comes in contact with. According to the statistical data revealed that the contamination rates of the United kingdom, the survey data has discovered the fact that on among 6 mobile phones used by the UK dwellers have been found to be heavily contaminated with fecal matter and microbes (Gov.uk 2018). The research study articulated by the Queen Mary’s school of Biological and Chemical Sciences and the London school of Hygiene and Tropical Medicine that focused on the 12 cities of the United Kingdom revealed that the most common bacteria found had been Escherechia coli, a pathogen of fecal orgin indicating at poor hygiene of the Britons. 95 per cent of people said they washed their hands with soap where possible, 92 per cent of phones and 82 per cent of hands had bacteria on them. Disturbingly, 16 per cent of hands and 16 per cent of phones were found to be contaminated with E. coli, bacteria of a fecal origin (Qmul.ac.uk 2018). Hence, it can be easily stated that the contamination from the washrooms or the toilet seat and can lead to severe infections such as food poisoning and diarrhea. Other common pathogens that contaminate the cell phones include MRSA, Bacillus spp, Viridans streptococci, etc.
Hence, according to the survey data it is clear that there is a significant risk of communicable disease outbreak in the UK residents due to the extreme risk of microbial contamination through the fecal contaminants and pathogens that have been found in the smart phones used (Best, Sandoe and Wilcox 2012). The survey mentioned above has also discovered the fact that the Britons have been found to be neglecting their personal hygiene and hand washing protocol as well. It has to be mentioned that in the present age of technological revolution, being connected to the world has become the need of the hour; and the Smartphone or tablets provide us with the opportunity to be connected with the world at all times. Hence, there is hope for the tech-savvy generation to stop using their smart phones or even limit the usage. Instead there is need for more extensive and detailed research to indentify the exact risk that the touch screen devices are presenting to the population so that the incidence risk of preventable infectious diseases can be reduced. Hence exploration of the issue to what extent microbial contamination is prevailing by the means of mobile phones and other electronic devices is the topic of research for the study.
The Research question designed for this study is:
“Do mobile phones and other related electronic devices act as a potential source of microbial contamination?”
The aims and objectives of the study are:
The null hypothesis for the project is:
Mobile phones and similar electronic devices are not a potential source of bacterial contamination.
Research design
The study will be designed in a way that helped to investigate the presence of bacterial contamination in touch screen phones, iPad, and tablets in the laboratory setting. The study will be a cross-sectional that will focus on observational data from a representative subset of a population, at a specific time period. The basic rationale of the study can be attributed to the fact that approximately 75% individuals, all around the world have an access to touch screen electronic devices, specifically mobile phones and tablets (Kamis et al. 2015). They have increasingly become an important means of communication, globally, owing to their easy access, economical standards and user-friendly techniques. Regardless of the huge achievements of these touch screen devices in the current scenario, there is no denying the fact that the electronic devices create several health hazards. Furthermore, these devices are most commonly used in places and environment that has high presence of bacteria. Touch screen devices are frequently used in research and medical laboratories during several activities that encompass collection of sample, their processing and microorganism culture (Selim and Abaza 2015).
Unlike the hands that can be easily disinfected, with the use of alcohol-based hand rubs (ABHRs), available across all medical facilities, hospitals and laboratories touch screen devices are most often cumbersome to clean. Efforts are seldom taken to disinfect them. This increases the potential of these devices for acquiring contamination with several bacterial agents. Hence, this increases the likelihood of the mobiles and tablets to get contaminated by a range of microorganisms, some of which might have a pathogenic nature (Pal et al. 2013). Furthermore, the microorganisms present on the devices might also have drug-resistant properties, which in turn would make the laboratory members more susceptible to suffering from a range of bacterial and viral diseases (Lee et al. 2013). This forms the foundation of the cross-sectional research that is intended to be conducted across a laboratory setting. The mobile phones, tablets and other touch screen devices are the independent variables in this research as their number and selection can be controlled or changed, within the laboratory setting. On the other hand, the measurable contamination of these devices will act as the dependent variable.
The cross-sectional study will be conducted over a period of 5 months (from July-November). The mobile phones, tablets and iPads will be taken from 50 participants that include me, my friends, family members, and professors, who will be randomly selected. Selection criteria will include individuals who always carry their electronic devices with them. These electronic devices will then be tested for bacterial contamination. A detailed informed consent form will be provided to each recruited participants that will contain exhaustive information about the purpose and probable benefits of the study. Following obtaining their informed consent, the enrolled participants will be provided with self-administered questionnaire that will cover specific questions on their demographic data. Questions will also be put regarding the frequency and pattern of use of the devices, in addition to the hygiene practices that are followed. Sterile cotton swabs, peptone water tubes, agar plates, and Quebec colony counters, used for the experiment need not be purchased for the experiment. The materials for double disk diffusion method and Kirby-Bauer antibiotic sensitivity test will be purchased for conduction of the research.
The touch screen devices will be aseptically collected with the use of sterile cotton swabs. Each swab will be will be moistened with the use of sterile peptone water. This will be wiped over the keys, screen, back panel, mouthpiece, and earpiece. All swabs will be streaked by SS method over surface of Blood- MacConkey agar plates. The cotton end of the swabs will be rinsed, followed by soaking in peptone water. The agar plates will be anaerobically incubated for 24hours at 37°C. The colonies isolated from the plates using SS method will be measured and counted in the form of organism/device. Quebec colony counter will be used to test the CFU/ml. The bacteria isolated will be tested for Gram staining and microscopically examined. Agar diffusion procedure will also be used to detect the antibiotic sensitivity of the bacteria that has been isolated. This will be performed by using the Kirby-Bauer antibiotic sensitivity test. The double disc diffusion procedure will be used testing the Gram negative isolates, for ESBL (extended spectrum beta-lactamase). Statistical analysis of the measurements will be conducted with the use of the SPSS version 21.0 software. Furthermore, the association between the types of bacteria recovered (CFU) with the kind of touch screen interface will be evaluated with the Fisher’s exact test. Significant independent factors will be analysed with the help of a multivariate analysis.
A huge rate of microbial contamination is expected in all the touch screen devices that will be selected for the study. Microbial contamination is expected to be higher for Staphylococci, Enterococcus spp., Streptococcus spp., Escherichia coli, and methicillin-resistant Staphylococcus aureus. No statistically significant differences are expected to occur in the rates of bacterial contamination, in all mobile phones, tablets and iPads taken from the 120 participants, based on department, gender, or frequency of use of these touch screen devices. However, lower rates of contamination might be observed in the touch screen devices owned by people who frequently practiced hand hygiene practices. This can be correlated with the questionnaire that will be duly filled in by the participants. Further outcomes might indicate presence of higher number of bacteria in mobiles and tablets that were never cleaned by the owners, compared to those that were recorded to get cleaned at times. Statistically significant results are also expected in the isolates between the PP method and SS method. The microorganisms isolated from the touch screen devices are also expected display high sensitivity towards ampicillin and methicillin.
The importance of the research in laboratory setting can be attributed to the fact that screening all touch screen devices for bacterial contamination, on a regular basis is crucial in healthcare and research laboratory settings. This will facilitate the use of appropriate hand hygiene practices and will lead to a successful implementation of infection control measures, thereby preventing the spread of harmful pathogens through these electronic devices, and reducing rates of nosocomial infections.
References
Best, E.L., Sandoe, J.A.T. and Wilcox, M.H., 2012. Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk. Journal of Hospital Infection, 80(1), pp.1-5.
Gov.uk. (2018). Health protection: Infectious diseases – GOV.UK. [online] Available at: https://www.gov.uk/topic/health-protection/infectious-diseases [Accessed 24 May 2018].
Jeon, Y.S., Chun, J. and Kim, B.S., 2013. Identification of household bacterial community and analysis of species shared with human microbiome. Current microbiology, 67(5), pp.557-563.
Kamis, K., Janevic, M.R., Marinec, N., Jantz, R., Valverde, H. and Piette, J.D., 2015. A study of mobile phone use among patients with noncommunicable diseases in La Paz, Bolivia: implications for mHealth research and development. Globalization and health, 11(1), p.30.
Lee, Y.J., Yoo, C.G., Lee, C.T., Chung, H.S., Kim, Y.W., Han, S.K. and Yim, J.J., 2013. Contamination rates between smart cell phones and non?smart cell phones of healthcare workers. Journal of hospital medicine, 8(3), pp.144-147.
Miko, B.A., Cohen, B., Haxall, K., Conway, L., Kelly, N., Stare, D., Tropiano, C., Gilman, A., Seward Jr, S.L. and Larson, E., 2013. Personal and household hygiene, environmental contamination, and health in undergraduate residence halls in New York City, 2011. PloS one, 8(11), p.e81460.
Pal, P., Roy, A., Moore, G., Muzslay, M., Lee, E., Alder, S., Wilson, P., Powles, T., Wilson, P. and Kelly, J., 2013. Keypad mobile phones are associated with a significant increased risk of microbial contamination compared to touch screen phones. Journal of Infection Prevention, 14(2), pp.65-68.
Pal, P., Roy, A., Moore, G., Muzslay, M., Lee, E., Alder, S., Wilson, P., Powles, T., Wilson, P. and Kelly, J., 2013. Keypad mobile phones are associated with a significant increased risk of microbial contamination compared to touch screen phones. Journal of Infection Prevention, 14(2), pp.65-68.
Pal, S., Juyal, D., Adekhandi, S., Sharma, M., Prakash, R., Sharma, N., Rana, A. and Parihar, A., 2015. Mobile phones: reservoirs for the transmission of nosocomial pathogens. Advanced biomedical research, 4.
Qmul.ac.uk. (2018). Contamination of UK mobile phones and hands revealed. [online] Available at: https://www.qmul.ac.uk/media/news/items/se/57395.html [Accessed 24 May 2018].
Selim, H.S. and Abaza, A.F., 2015. Microbial contamination of mobile phones in a health care setting in Alexandria, Egypt. GMS hygiene and infection control, 10, Doc03.
Verani, M., Bigazzi, R. and Carducci, A., 2014. Viral contamination of aerosol and surfaces through toilet use in health care and other settings. American journal of infection control, 42(7), pp.758-762.
Walia, S.S., Manchanda, A. and Narang, R.S., 2014. Cellular telephone as reservoir of bacterial contamination: myth or fact. Journal of clinical and diagnostic research: JCDR, 8(1), p.50.
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