Multidrug-resistant bacterial contamination of healthcare workers’ mobile phones, decontamination efficacy, and potential implications for hospital-acquired infections

Abstract

Abstract Mobile phones are indispensable clinical tools for healthcare workers (HCWs), yet remain largely unaddressed within infection prevention and control (IPC) frameworks. Repeated handling during patient care combined with inconsistent disinfection may allow these devices to serve as multidrug-resistant (MDR) organism reservoirs contributing to healthcare-associated infections (HAIs). A hospital-based cross-sectional analytical study with an embedded intervention and post-intervention follow-up was conducted at Menoufia University Hospitals, Egypt (2025–2026). Swabs from 300 HCWs’ mobile phones across eight clinical areas were processed microbiologically and confirmed by Vitek 2. Antimicrobial susceptibility testing followed the Clinical and Laboratory Standards Institute (CLSI) 2025 guidelines. Bacterial burden was quantified by colony-forming units (CFU; low < 50, moderate 50–200, high > 200). Extended-spectrum β-lactamase (ESBL) and carbapenemase production were phenotypically confirmed, then genotypically characterized by multiplex PCR (blaTEM, blaSHV, blaCTX-M, blaOXA-48, blaNDM, blaIMP, blaVIM, blaKPC). Four decontamination methods were evaluated, and ward-level HAI rates correlated with MDR prevalence. Overall, 270/300 (90.0%) phones were contaminated, and 179/300 (59.6%) carried MDR organisms, with the highest burden in the intensive care unit (ICU). Coagulase-negative staphylococci (CoNS; 29.4%) and S. aureus (25.4%), including methicillin-resistant strains (MRSA), predominated. Among Gram-negative isolates (n = 169), ESBL production was detected in 24.9% and carbapenemase in 13.0%; blaTEM (13.6%) and blaOXA-48 (4.7%) were most prevalent, respectively. Sodium hypochlorite–impregnated wipes achieved the greatest bacterial load reduction (96.5%). Only 9.0% of HCWs reported daily phone disinfection; phone use during invasive procedures was the strongest MDR risk factor (adjusted odds ratio [AOR] 2.9; p < 0.001). At the ward level, MDR prevalence was strongly correlated with HAI rates (r = 0.986; p < 0.001). Post-intervention reductions in contamination (90.0%→78.0%), MDR carriage (59.6%→45.0%), and mean CFU (190.1 ± 80.3→95.5 ± 55.2) were all significant (p < 0.001). HCWs’ mobile phones are potential reservoirs of MDR organisms, including clinically important ESKAPE-associated pathogens. Integrating standardized phone hygiene into IPC programs, supported by evidence-based decontamination and molecular surveillance, is warranted, particularly in high-acuity clinical settings.