Comparison of microbial flora isolated from mobile phones for different population

sectors

Waad Ibrahim Mohamed Almatir

Mannar Ahmed Hamad Alabd Alwahab

Medical Laboratories Department

College of Applied Medical Sciences- Shaqra
Shaqra University

1
 Table of Contents

Content Page
Abstract 3
Introduction 4
Objectives 5
Materials and Methods 6
Results 8
Discussion 16
Conclusion 17
References 18
Arabic Abstract 20
List of Tables:

Table Page

Table 1: distribution of the investigated sample 9

Table 2: Bacteria isolated form mobiles 9

Table 3: Fungi isolated from mobile phones: 10

List of figures

Figure page
Fig 1:Gram stain: : shows gram positive cocci 11
Fig 2:Gram stain: shows gram negative rods 11

Fig 3: Gram stain: shows gram positive Candida 12

Fig 4:Gram stain: shows lactic acid bacteria 12

Fig 5 ; Grows of Stsphylococcus aureus on Mannitol Salt Agar 13

Fig 6: Growth of gram negative bacteria on MacConkeyAgar 13

Fig 7: Growth of Nocardia sp.on Blood Agar 14

Fig 8: Candida growth on SDA 15
Fig 9: API test for identification of bacteria 16

2
 Comparison of microbial flora isolated from mobile phones for different population
sectors.

ABSTRACT

Now mobile phones are used for communication between different sectors of society especially
professionals, university staffs and health care personnel. This study estimate and identifies the
bacterial contamination rate of mobile phones in the university students that are in frequent contact
with faculty members, Security Cleaners, Lab specialist and markets workers. A total of 115 mobile
phones belonging to different sectors in Shaqra province KSA were screened for microorganisms’
contamination. Results: Out of the total 115 mobile phones, growth was obtained in 93 (80.9%).
Staphylococcus aureus was the most commonly isolated organisms 69 (79%) also Coagulase
negative Staphylococcus was the most frequently isolated 60(69%). E. coli and Bacillus sp. were the
most commonly isolated organisms 47(54%).It was found that around 8( 80% )of the mobile phones
of Lab specialist workers at Shaqra hospital were contaminated and thus acted as a potential source
of nosocomial infections. Methodology: According to morphological, physiological characteristics,
API profiles were identified among the selected isolates.

Conclusion & recommendations: Thus mobile phones can be heavily colonized by high quantities
of pathogenic bacteria and thus potential sources of disease transmission requiring application of
sound personal hygiene as preventive methods.

3
INTRODUCTION

Today, mobile phone (also known as a cellular phone, cell phone or a hand phone) is a tool
that has became one of the most essential accessories of our occupational and social life. In
addition to the standard voice function of a telephone, mobile phones can favor many
additional services such as SMS for text messaging, email, pocket switching for Internet
access, and MMS for sending and receiving photos and video. Mobile phones have gone from
being rare and expensive pieces of equipment used primarily by the business choice, to a
common low-cost personal item. With all the accomplishment and advantage of the mobile
phone, it is easy to overlook the health hazard. Mobile phones can become a tool for
transmission of micro-organisms duo to users’ lack of personal hygiene, and the use of the
mobile phone by more than one person. This constant handling of the phone by different users
caused it to be a good carrier for microbes, especially those associated with skin infections
resulting in the spread of different microorganisms from a user to another. Mobile phones
could be contaminated through sources such as human skin or hand, phone pouch, bags,
pockets, environment and food particles, these sources are links through which
microorganisms colonized the phone, thus causing diseases that range from mild to chronic.
Further, sharing of mobile phones between people may directly facilitate the spread of
pathogenic bacteria to the community and become reservoir for microorganisms.

At present, Asia has the fastest growth rate of cellular phone subscribers in the world
however; Saudi Arabia ranks first globally in mobile phone use and Mobile Apps in the Arab
World. This can be attributed to the positive economic situation, which this country is
witnessing, and the increasing number of consumers with high purchasing power. Also, the
widespread use of the Internet in the Saudi community and the growing presence of foreign
workers, who constantly communicate with their employers and countries of origin, are
reasons behind Saudi Arabia leads in mobile phone’s technology.

Mobile phones could be a health hazard with many microbes living on the phone.
Staphylococci, particularly S. epidermidis are members of the normal flora of the human
skin, respiratory and gastrointestinal tracts (Jayachandra et al 2011). S. aureus can be also
found on the skin and in the noses which can cause illnesses from pimples and boils to
pneumonia and meningitis, and is a close relative of Methicillin Resistant Staphylococcus
aureus (MRSA) (Sumritivanicha et al 2011). Furthermore, the hand serves as a major vehicle
of transmission of various microbes. E. coli and related bacteria constitute about 0.1% of
gut flora, and fecal-oral transmission is the major route through which pathogenic

4
strains of the bacterium cause disease (Ezhilarasan et al 2010). Proteus mirabilis is one
of the most common Gram-negative pathogens. It can cause a variety of community- or
hospital-acquired infections, including those of the urinary tract, respiratory tract, wounds and
burns.

General Objective:

-To screen mobile phones for possible microbial flora from different sectors of the
community.

Specific objectives:

-To isolate microorganisms from mobile phones surfaces.

-To identify the isolated organisms.

-To recommend and propose a better handling for mobile phones if needed.

5
Materials and Methods

Study Design: Experimental cross sectional

Area of study: Shaqra Province.

Study Population: People living in Shaqra

Study Sample: Students, Staffs, Security, cleaners, Lab specialist at Shaqra hospital and
workers in meat and fish markets.

Sample size: 115 mobile phones

Sampling technique: Random convince sampling

Methods

Samples from the mobile phones of all participants from the campus were collected randomly
during routine daily work, and each was asked regarding hygiene practices that is, if she ever
cleaned her mobile phone or washed his hand after toilet. A sterile cotton swab was rolled
over all exposed outer surfaces of the cell phones which were used. Care was taken to make
sure that the buttons were swabbed, and then sampled swabs were streaked over blood agar,
Mannitol salt agar, MacConkey agar plates and Sabaraud’s dextrose agar. Plates were
incubated aerobically at 37°C for 24-48 h while Sabaraud’s dextrose agar plates were
incubated at 25°C for 2-3weeks

Isolation of organisms

Colonies showing a good growth and characters on plates were picked and streaked on new
blood agar, Mannitol salt agar, MacConkey agar plates and Sabaraud’s dextrose agar. A
rapidly growing, visually distinct colony and a separate, morphologically unique isolates were
selected for further analysis and purified by repeated plating.

Identification of organisms

Pure isolated colonies were gram differentiated and then biochemical identification done;
using catalase, oxidase, and Coagulase tests, and then an API test was performed. A slide
coagulase test differentiated staphylococcal isolates into S. aureus and coagulase-negative
staphylococci (CoNS) were performed. Isolates were purified, identified and named based on
the morphological, physiological and the biochemical characteristics presented in Bergey's
Manual of Determinative Bacteriology (Holt et al., 1994) and using the standard kits API

6
identification system (Biomerieux, Marcy L’etoil, France) for the identification of both gram
positive and negative.

RESULTS

Seven groups of participants of Shaqra province show: students, Security, Cleaners, Lab
specialist, Teaching staff, Meat and fish workers were examined. The rate of bacterial
contamination of mobile phones was 80.9%. The highest rate of contamination of personal
mobile phone was recorded in cleaners (93.3%) and the lowest was recorded in Meat and fish
workers (60%) (Table 1). Microorganisms from person hands could be transferred to the
surfaces of the mobile phones during their use.

All mobile phones were contaminated with different species of pathogenic bacteria, S. aureus,
the common bacteria that live on skin can cause illness. E. coli, are fecal in origin. The likely
reason is that people do not wash their hands after using the toilet which means that people
spread fecal bacteria not just to their phones, but to everything else they touch around them.
E. coli can survive on hands for hours and is easily transferred to door handles, computer
keyboards and food. All 115mobile phones sampled were contaminated with varied numbers
of bacteria (Table 2-3). The isolates included S. aureus,( 79%), Coagulase negative
Staphylococci,( 69%), E. coli (54%), Bacillus (54%), Enterobacter fecalis(26%) , Proteus
mirabilis (26%), Dephtroids (26%), Lactic Acid Bacteria (Cyanocobalamin) (26%),
Enterobacter argenosa (17%)and Nisserea (16% ). Candida sp. (8.6% ), Aspergillus
flavus(2.15% ), Aspergillus fumagatus (2.15% ), Nocardia sp(5.37) S. aureus, and coagulase
negative staphylococci isolates were more isolated from the total isolates.

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Table 1: Distribution of the investigated sample

Category Sample size Growth Contamination %

1 Students 45 40 88.9

2 Security 15 10 66.7

3 Cleaners 15 14 93.3

4 Lab specialist 10 8 80

5 Teaching staff 10 9 90

6 Meat workers 10 6 60

7 Fish workers 10 6 60

Total 115 93 80.9

Table 2: Bacteria isolated form mobiles

Isolate Number of occurrence in Percentage rate

Mobil phones

Staphylococcus aureus 69 79%

Staphylococcus epidermidis 60 69%

Enterobacter fecalis 23 26%

Dephtroids 23 26%

Bacillus sp. 47 54%

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E. coli 47 54%

Proteus mirabilis 23 26%

Lactic Acid Bacteria (Cyanocobalamin) 23 26%

Enterobacter argenosa 15 17%

Nisserea 14 16%

Table 3: Fungi isolated from mobile phones:

Isolate Number of occurrence Percentage rate

Candida sp. 8 8.6

Aspergillus flavus 2 2.15

Aspergillus fumagatus 2 2.15

Nocardia sp 5 5.37

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Fig 1: Gram stain: shows gram positive cocci

Fig 2: Gram stain: shows gram negative rods

11
Fig 3: Gram stain: shows gram positive Candida

Fig 4: Gram stain: shows lactic acid bacteria

11
Fig 5 ; Grows of Staphylococcus aureus on Mannitol Salt Agar

Fig 6: Growth of gram negative bacteria on MacConkeyAgar

12
Fig 7: Growth of Nocardia sp.on Blood Agar

Fig 8: Candida growth on SDA

13
 Fig 9: API test for identification of bacteria

Discussions

Mobile phones became reservoirs of pathogens that could result in infections due to its
proximity usage. Our study shows that high levels of bacterial contamination of mobile
phones used by students. Depending on the environmental conditions, pathogens may remain
infectious on a surface for weeks once contaminated. In humid conditions, pathogens may
transform a passive reservoir into an active one, which is capable of causing diseases in
anyone who gets contaminated while using the mobile phone.

A total of 115 mobile phone swabs were analyzed for the presence of microorganisms. Out of
this number, about 93 (80.9%) of the phones demonstrated evidence of bacterial
contamination, especially among students and staff members in the University of Shaqra, with
different types of bacteria. Similar studies conducted by Killic I. H. et al. (2009).have
reported 61.3% and 72% contamination of mobile phones respectively. Other studies
conducted by Karabay et al.(2007). have shown higher rate of mobile contamination,90.98%,
94.5%, and 95% respectively .

The high percentage of isolates from mobile phones was attributed to the poor hygienic and
sanitary practices and the students and staff members’ attendance with patients in hospitals
and clinic of the Faculty of Applied Medical Sciences. However, the high percentage of
isolates from mobile phones in marketers with low level of education especially those

14
involved in handling raw meats and fish. Staphylococcus aureus is the major contaminant of
the mobile phones with 79% incidence rate. Similarly, a study conducted by (Tambekar D. H.
et al.2007) hasreported that Staphylococcus aureus as the major pathogen, 20% . Ekrakene
and Igeleke (2007) also reported that S.aureus was isolated from the mobile phones of health
care staff. The main reservoir of S. aureus is the hand, from where it is introduced into food
during and after food preparation (Hui etal., 2001).

The high isolation of Coagulase Negative Staphylococci confirms its ubiquitous nature, the
great colonization ability as well as the ability to resist environmental changes on skin.
Moreover, it can withstand dry heat and certain chemical disinfectants for moderate periods of
time (Brooks et al., 2007)

Isolation of Coagulase negative Staphylococci was predominant in our study about 69%,
which conforms with the results obtained by (Killic I. H. et al.2009) have found Coagulase
negative Staphylococci isolation 68.4%, 60% and 58.96% respectively.Isolation of Coagulase
negative Staphylococci was predominant in our study. 69% which is similar with study of
Killic I. H. et al.(2009). who found Coagulase negative Staphylococci isolation 68.4%, 60%
and 58.96% respec-tively .

Enterobacter aerogenes and Enterobacter fecalis , Proteus mirabilis, Neisseria and Bacillus
sp. are the main bacterial isolatesfrequently associated with mobile phones as shown in Table
3. These organisms have found their way into the phone through the skin and transmitted
regular skin contact. This is because the isolated bacteria are normal microflora of the skin.
Frequent handling by many users with different hygiene profiles will cause contamination by
these pathogens ( Ekrakene T, Igeleke CL., 2007).

Bacillus spp. is a normal flora found in the water, raw vegetables and cooked food. It can
cause food poisoning through eating with infected hands (Jay, 2000).The presence of the
gram-negative rod, E. coli (47 isolates) Enterobacter aerogenes,a member of the coliforms,
indicates the presence of fecal contamination on the mobile phone. This is in agreement with
the work done by (Brooks et al., 2007).

The fungal growth reported in our study was found to be (Table 3) similar to results reported
by (Ugler et al., 2009) where fungal growth in 7.49% and 1.54% was reported respectively.

The presence of the isolated fungi refers to food particles, soil particle and spoiled dirt in the
pouch or pocket over a long period of time. It will favor the growth of saprophytic fungus,
which can cause infections like Aspergillosis, food intoxication and allergic reactions if these

15
spores are introduced into foods, drinking water, or inhaled (Flavia et al., 2001). (Al-
Abdalall,2010). These pathogens may cause food borne infections, brain disorder, cancer,
headache, nosocomial infections, and cellular damage (Neely and Sittig, 2002).

Conclusions:

Sample from mobile phones were collected from different sectors of society. These samples
were found to be highly contaminated with various types of bacteria. This proposes the theory
that mobile phone can be considered as a tool caused in community-acquired infections with
possible public health implications. Therefore, periodic cleaning of mobile phones with
disinfectants or hand cleaning detergents, as well as frequent hand-washing, should be
encouraged as means of prevention of disease transmission. Bacterial flora on mobile phones
of the faculty members may vary from that found on mobile phones of non- faculty members
because staffs, students and Lab specialist mobile phones were contaminated with various
types of microorganisms and became a source of nosocomial infections at hospitals.
Consequently, mobile phones act as an easy way for transfer of potential pathogens associated
with nosocomial and other infections. Decontamination of mobile phones with alcohol
disinfectant wipes as well as regular hand washing should be performed regularly to prevent
infections.

References:

Al-Abdalall, A.H.A., 2010. Isolation and identification of microbes associated with mobile
phones in Dammam in Eastern Saudi Arabia. J. Farm. Community Med., 17: 11-14.

Brooks GF, Carrol KC, Butel JS, Morse SA (2007). Jawetz, Melnick, and Adelberg’s Medical
Microbiology, 24th Ed. McGrawHill, USA.

Brooks GF, Carrol KC, Butel JS, Morse SA (2007). Jawetz, Melnick, and Adelberg’s Medical
Microbiology, 24th Ed. McGrawHill, USA.Contamination of the food, despite washing hands
after Francisco

Cordeiro Neto,( 2001). Isolation of using the toilet hence mobiles phones should not be
filamentous fungi from public telephones of the metropolitan region of the city of Recife, Pe,
Brazil.

E krakene T, Igeleke CL (2007). Micro-organisms associated with public mobile phones

along Benin-sapele Express Way, Benin City, Edo State of Ezhilarasan Rajaram, Suchitra

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Sudharsanam, Anandhi Lakshman, Kalyani Jagannathan., (2010), Mobile phones:
Emerging threat for infection control, Journal 1-of infection prevention, 11, pp 87-90.

Flavia Paiva Coutinho, Marilene da Silva Cavalcanti and Holt JG, Krieg N R, Sneath, PH,
Staley A, James T, Willims ST (eds.) (1994). Bergey's Manual of Determinative
Bacteriology, 9th edition. Baltimore: Williams and Wilkins.

Hui,Y,H.,D ,Kitts and P,S,Stanfield (2001)Food borne diseases Hand book 2nd edu, vol 4
seafood and environmental toxins.

Jay, M.I., 2000. Food Microbiology. 6th Edn., Van Nostr and Reinhold Pub. Co., Berkhire.

Jayachandran1, P. T.; C. Watson1,; I. J. Rae2,; J. W. MacDougall3,; D.

Karabay, O., Kocoglu, E. and Tahtaci, M. (2007) The role of mobile phones in the spread of
bacteria associated with nosocomial infections. Journal of Infection in Developing Countries,
1, 72-73.

Killic, I.H., Ozaslan, M., Karagoz, I.D., Zer, Y. and Davatoglu, V. (2009): The microbial
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Neely, A.N. and D.F. Sittig, 2002. Basic microbiologic and infection control information to
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Nigeria. J. Appl. Sci. Res. 3:2009-2012.

Sumritivanicha A. , K. Chintavavilas, A. Apisarntha Narak., (2011), Prevalence and type of

microorganism isolated from house staff’s mobile phones before and after 1- alcohol
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Tambekar, D.H., Gulhane, P.B., Dahikar, S.G. and Dudhane, M.N. (2008) Nosocomial
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W. Danskin4,; R. Chadwick1,; T. D. Kelly1, ... Article first published online: 15 DEC 2011.

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 ‫الملخص العربي‬

‫اآلن يتم استخدام اهلواتف احملمولة لالتصال بني خمتلف قطاعات اجملتمع وخاصة املهنيني واملوظفني اجلامعيني والعاملني يف جمال‬

‫الرعاية الصحية‪ .‬وهذه الدراسه حتدد وتقدر معدل التلوث اجلرثومي للهواتف النقالة بني طالب اجلامعات اليت هي يف اتصال دائم‬

‫مع أعضاء هيئة التدريس‪ ،‬وعامالت النظافه‪,‬و األمن‪ ،‬واخصائي املخترب باملستشفي وعمال األسواق‪ .‬وكان جمموع اهلواتف النقالة‬

‫اليت خضعت للدراسه ‪115‬نقال وكانوا مجيعا ينتمون إىل قطاعات خمتلفة يف حمافظة شقراء‪ ،‬باململكه العربيه السعوديه وقد مت اخذ‬

‫مسحات من علي أسطح اهلواتف النقالة وجوانبها وفردها علي املستنبتات املختلفه لعزل وتصنيف الكائنات احلية املمرضه املوجوده‬

‫علي اهلواتف النقالة وفقا للخصائص الفسيولوجية و املورفولوجية‪ ،‬مث مت حتديد مالمح ‪ API‬بني العزالت املختارة ‪ .‬النتائج‪ :‬كانت‬

‫املكورات العنقودية الذهبية املعزولة هى الكائنات األكثر شيوعا بنسبة ‪٪69, %79‬كانت نسبة عزل اإليشرييشا كوالي بينما‬

‫كانت نسبة عزل العصويات ‪47%.‬‬

‫االستنتاج والتوصيات‪ :‬اهلواتف احملمولة تعترب مساعد يف نقل وانتشار الكائنات الدقيقة املسببة لألمراض وعليه ننصح باتباع الطرق‬

‫الصحية السليمة و النظافة الشخصية الدائمة و الدوريه للجهاز النقال‪.‬‬

‫‪18‬‬