Bacterial pathogens are colonized on human host and inanimate objects but most people don’t realize that bacteria are found on many common objects in the outdoors, in their workplaces and homes (Jaya Madhuri et al., 2015). Cell phones are often used by both healthcare workers and patients as they are an effective means of communication for both categories. A number of recent studies have exposed how cell phones belonging to healthcare workers establish a device on which various microorganisms linked to nosocomial infections can congregate (Bodena et al., 2019; Selim & Abaza, 2015). Our results confirm the high relationship between the rates of positive tests regarding the colonization of hands and cell phones, detected for all the microorganisms identified.

A nine aerobic bacterial species have been isolated from 93(91%) of the examined cell phones and the highest rate of isolation bacteria collected from Nurses, doctors, patients, microbiologist, medical colleges student and chemists sequentially, this has been confirmed by the study of Bodena et al which close enough to our rate with 94.2% (Bodena et al., 2019), Jaya Lakshmi in 2008 with 91.6% of the samples and Saudi study done by Zakai et al. with 96.2% of 105 samples (Zakai et al., 2016). This rate more than the percentage of Tiwari et al which was 76.2% (Tiwari et al., 2016).
Microbes present in hospitals which mainly multi-resistant to antibiotic due to aerosol, gloves contamination and spreading of bacterial contamination by health worker themselves. These organisms replicated rapidly and adhere to any available surface such as cell phone carried by the health-care workers. The problem may become more serious, if HCWs become a potential source for transfer of these organisms during invasive procedures and may lead to nosocomial infections (Jaya Madhuri et al., 2015).

In this study, the incidence of E.coli isolations which collected from the cell phone surface, may be associated to fecal and patient contamination. Most of the pathogenic bacteria isolated from Nurse and Doctor phones which could be expected result; but none of these pathogenic bacteria were isolated from chemist and under-graduated students’ cell phones, probably because the low levels in which pathogens are present on the surface of these devices and they are lesser in direct contact with patients or their specimens. These results are similar to Mexican study done by Martinez-Gonzales et al. :2017. Other Iraqi study done by Mohammad in 2017 was found that positive culture in 52% of samples and higher positive culture found in mobile of technician, followed by doctors (Auhim, 2013).
In the present study, most bacteria isolated were Coagulase negative Staphylococci epidermidis (28%), then Escherichia coli (22%), Klebsiella pneumonia (16%), Pseudomonas aeruginosa (13%), Staphylococcus aureus (12%), Bacillus spp. (5%), Enterobacter spp. (3%). and Proteus spp. (1%). The results were in accordance with study done by Tiwari et al demonstrated the most common organism detected was Staphylococcus epidermidis (25.42%) and E.coli (25.42%)( Tiwari et al., 2016); While Zakai et al in 2016 found that Coagulase negative Staphylococci epidermidis were the most abundant isolates 68%.

Positive bacteria for Gram stain, Staphylococcus spp. was 40% from all isolated bacteria, which was also found in studies showed by others (Bodena et al., 2019; Lakshmi & Lakshmi, 2014) and S.epidermidis was the most predominant and frequent then S.aureus from mobile phones in this study Ulger et al in 2009 which like our results . However, Staphylococci species are normal skin flora, these organisms have the potential to harbor and transfer drug resistance gene among their genera or beyond.

According on environmental circumstances, bacteria could remain infectious agents on cell phone surfaces for days or weeks after being contaminated. In humidity, pathogens may re-activation and colonized the surfaces, transforming a passive reservoir into an active one. Furthermore, formation of biofilm by one bacterial agent can affect the survival of other pathogens on the same surface (Tagoe et al., 2011). Shakir and his colleagues found that samples were collected from 53 cell phones by culturing on media, pathogenic bacteria grow on 44 cultures which mean 83% of collected phones contaminated. (Shakir et al., 2015).

Significantly, we found that no patients in our study have shared a cell phone through their hospitalization period. However, this behave could reduce the possibility of bacterial cross-contamination, many stated that they would share their phone if asked. Therefore, Patients in hospitalization period should be given advice to avoid sharing cell phones with other patients in order to mitigate the potential risk of cross-contamination (Brady et al., 2011).

Nevertheless, consistent with our statistical analysis data, there was no relationship between type of phone and usage of phones in toilets and the presence of contamination with bacteria (p = 0.075). But there is a correlation between age and type of work jobs because increasing in time of using phone in younger individuals. Previous studies shown that near to 20% of doctor and nurse cell phones are contaminated with multi-antibiotic resist pathogenic bacteria (Jayalakshmi et al., 2008).

Fig. 1. Bacteria species that isolated from personal cell phones

The Present study did not check the efficiency of various chemical disinfectants for cleaning of mobile phones which needs and detecting the resist for more antibiotic to be done in future. The aggregate implication of this result is that the cell phones which are meant to make communication easy are gradually assuming the status of pathogenic agent of disease transmission (Lakshmi & Lakshmi, 2014).

Table (1):
Distribution of examined populations and growth bacterial patterns.