New Evidence of Silent Fomites: Could Smartphones Be Compromising ICU Infection Control?

The study was published in the National Journal of Medical Research in July 2025.

While smartphones enhance clinical communication, they are often omitted from standard disinfection protocols, allowing them to act as fomites for multidrug-resistant organisms. This oversight creates a significant clinical gap. Consequently, author Aishwarya J Hinde of the Department of Microbiology at Jawaharlal Nehru Medical College, KAHER, Belagavi, and colleagues aimed to evaluate the prevalence and specific types of microbial contamination on smartphones used by nursing personnel immediately after completing their shifts in various ICUs.

The cross-sectional study and systematic random sampling collected swabs from 129 smartphones of ICU nursing staff for microbial culture. Pathogens were identified per Clinical and Laboratory Standards Institute (CLSI) guidelines, while chi-square tests analyzed the link between contamination and cleaning habits.

Key Clinical Findings of Study:

• High Microbial Prevalence: The study revealed that 64.3% of smartphones used in the ICU harbor pathogenic bacteria, with 61% exhibiting monomicrobial growth.
• Staphylococcal Dominance: Clinically, gram-positive cocci were the most prevalent organisms at 82.7%, with Staphylococcus aureus identified as the leading pathogen on 36.4% of all tested devices.
• Gram-Negative Diversity: Approximately 17.2% of isolates were gram-negative bacilli, including high-risk species such as Escherichia coli (40%), Klebsiella pneumoniae (26%), and Pseudomonas aeruginosa (20%).
• Hygiene Correlation: There is a significant statistical association between low cleaning frequency and increased bacterial colonization, confirming that smartphones act as persistent reservoirs when not routinely disinfected.
• Consistent Risk Profile: Demographic factors like age, gender, and years of work experience did not significantly impact contamination levels, indicating that the risk is uniform across the clinical workforce.

The results suggest that smartphones in the ICU serve as significant reservoirs for pathogens, with 64.3% of devices harboring bacteria that can contribute to healthcare-associated infections (HAIs). To mitigate this risk, the study promotes routine disinfection, guided by evidence-based protocols.

The study encourages clinicians to view smartphones with the same infection control rigor as standard medical equipment. To mitigate transmission risks, the authors recommend the formal integration of mobile hygiene into institutional safety protocols, specifically advocating for regular disinfection with alcohol-based solutions and consistent hand hygiene following device usage.

Reference

Shinde AJ, Soumya S, Bin Najeeb MA, Jangid S. Surface Microbiology of Smartphone Screen Among the Nursing Staffs Working in Intensive Care Unit (ICU) of Tertiary Care Hospital. Natl J Med Res 2025;15(03):184-188. DOI: 10.55489/njmr.150320251120.