Prevalence and Factors Associated with Microbial and Methicillin-Resistant Staphylococcal Contamination of Smartphones Among Medical Students at Six Universities in Klang Valley, Malaysia

Background/Objectives: Smartphones used by medical students may serve as reservoirs for microbial contamination and contribute to the transmission of healthcare-associated microorganisms. This study aimed to determine the level of microbial contamination of smartphones, prevalence of methicillin-resistant Staphylococcus species (MRSS), and associated risk factors among undergraduate medical students in Klang Valley, Malaysia. Methods: An analytical cross-sectional study was conducted among students from three public and three private universities using convenience and snowball sampling. Demographic, behavioural, and environmental data were collected via an online questionnaire. Smartphone swabs were cultured to determine total viable count (TVC). MRSS were identified using enrichment and selective culture, Gram staining, 16S rRNA PCR-sequencing, and cefoxitin disc diffusion. Descriptive statistics, Fisher’s exact test, and multivariable binary logistic regression were performed. Results: A total of 148 smartphones were analysed. High microbial contamination (≥13 CFU per smartphone sampling unit, 75th percentile of TVC) was detected in 38 (25.7%) smartphones, while MRSS were recovered from 9 (6.1%) smartphones; all were methicillin-resistant coagulase-negative staphylococci: Staphylococcus epidermidis, Staphylococcus haemolyticus, and Staphylococcus ureilyticus. Male students (adjusted odds ratio [AOR] = 2.497, p = 0.025) and students from public universities (AOR = 2.730, p = 0.016) were more likely to have highly contaminated smartphones. MRSS contamination was associated with high microbial contamination (OR = 12.194, p = 0.001) and those living with elderly individuals (OR = 6.304, p = 0.013). Following the study, participants received their culture results, smartphone hygiene education through a dedicated website, and alcohol swabs as part of a health promotion initiative. Conclusions: This study highlights smartphones as potential fomites for the transmission of antimicrobial-resistant staphylococci. Integrating microbiological surveillance with targeted smartphone hygiene promotion may help reduce microbial contamination and the potential for transmission in healthcare training environments.