DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161745

Are doctor’s hands contributing in spreading nosocomial pathogens? Rapid appraisal from a tertiary care health center of Northern India

Shewtank Goel, Rakesh Tank, Abhishek Singh, Sanjeev Kumar Khichi, Ravi Bypareddy, Pooja Goyal, Jayaprakash Karkala

Abstract


Background: Clinical white coats have very long history of being a symbol of hope and healing for medical professionals; however there has been a concern that white coats may play a big role in transmitting infections within and outside hospital settings.Aim of the study was to assess pattern of pathogenic bacteria on the hands of doctors of a tertiary care hospital along with effect of hand wash on reduction of contamination.

Methods: The present study was a hospital based, cross sectional type. Eighty-six doctors of all designations (Junior doctors, n=51; and senior doctors, n=35) were included in this study. The swabs were taken at entry in the wards and also at exit from the wards without washing the hands. Then, swabs were taken after hand washing with tap water and subsequently after alcohol swabs. A total of four wards (2 General Medicine and Surgery wards each) included in the study. Isolated microorganisms were identified using Gram’s stain, hemolysis patterns and colony morphology. The data were analyzed using MedCalc statistical software.

Results: Staphylococcus aureus was isolated in 24.41% at entry and in 52.33% at exit. Similarly Pseudomonas aeruginosa and Klebsiella pneumonia were not present on the hands of doctors at entry but isolated in 5.81% and 10.46% of doctors at exit. Pseudomonas aeruginosa and Klebsiella pneumonia were not present on the hands of doctors at entry in both medicine and surgery wards but isolated at exit. Complete removal/reduction of microorganism (100%) was recorded in Escherichia coli and Candida sp after tap water wash. Decrease in count of Pseudomonas aeruginosa up to 80.00% after tap water wash. 88.89 % decrease in microorganism after subsequent alcohol wash was seen in Staphylococcus aureus, Coagulase-negative Staphylococci and Klebsiella pneumonia. Conclusions: It has been observed that simple hand washing (first with water and then with alcohol) is an effective tool to reduce the contamination significantly. Thus, hospital infection control practices including hand washing need to be followed strictly.

 


Keywords


Nosocomial pathogens, Doctor, Hands, Patients, Ward and tertiary care hospital

Full Text:

PDF

References


Bolyard, EA, Tablan, OC, Williams, WW, Pearson, ML, Shapiro, CN, and Deitchman, SD. The Hospital Infection Control Practices Advisory Committee: Guideline for infection control in healthcare personnel. 1998;19(6):407-63.

Schaberg DR, Culver DH, Gaynes RP. Major trends in the microbial etiology of nosocomial infection. Am J Med. 1991;91:S72-5.

Kampf G, Kramer A. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clinical Microbiology Review. 2004;17(4):863-93.

WHO. Prevention of hospital-acquired infections. A practical guide, 2nd edition, Eds. Ducel, G. Fabry, J. and L. Nicolle, Malta, WHO. 2002.

Loh W, Ng VV, Holton J. Bacterial flora on the white coats of medical students. Journal of Hospital Infection. 2000;45(1):65-8.

McAdam AJ, Onderdonk AB. Laboratory Diagnosis of Infectious Diseases. In: Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser SL, Jameson JL, et al. editors. Harrison’s Principles of Internal Medicine. 17th ed. USA: McGraw Hill. 2008;e97- 105.

Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disc method. Am J Clin Pathol. 1966;45:493-6.

Jeske HC, Tiefenthaler W, Hohlrieder M, Hinterberger G, Benzer A. Bacterial contamination of anaesthetists hands by personal mobile phone and fixed phone use in the operation theatre. Anaesthesia. 2007;62:904-6.

Nzeako BC, Daughari HA, Lamki ZA, Rawas OA. Nature of bacteria found on some wards in Sultan Qaboos University Hospital, Oman. Br J Biomed Sci. 2006;63:55-8.

Gunasekara TD, Kudavidanage BP, Peelawattage MK, Meedin F, Guruge LD, Nanayakkara G, et al. Bacterial Contamination of anaesthetists hands, personal mobile phones and wrist watches used during theatre. Sri Lanka J Anesthesiol. 2009;17;11-5.

Sen R, Keaney M, Trail A, Howard C, Chadwick P. Hand washing healthcare workers washed their hands on only a third occasions. BMJ. 1999;319:518.

Peacock JE Jr, Marwick FJ, Wenzel RP. Methicillin-resistant Staphylococcus aureus: Introduction and spread within a hospital. Ann Intern Med. 1980;93:526-32.

Pawar M, Mehta Y, Purohit A, Trehan N, Daniel RV. Resistance in gram-negative bacilli in a cardiac intensive care unit in India: Risk factors and outcome. Annals of Cardiac Anaesthesia. 2008;11:20-6.

Khan MU, Siddiqui KM. Hand washing and gloving practices among anaesthetists. Journal of Pakistan Medical Association. 2008;58(1):27-9.

Jeffrey B, Fretz F, Ann RN, Dennis L, James TK. High rate of hand contamination and low rate of hand washing before infant contact in a neonatal intensive care unit. Pediatr Infect Dis J. 1996;5:908-10.

Casewell M, Phillips I. Hands as a route of transmission for Klebsiella species. BMJ. 1977;2: 1315-7.