Importance of hand germ contamination in health-care workers as possible carriers of nosocomial infections

Abstract

The importance of hands in the transmission of nosocomial infection has been world wide admitted. However, it is difficult to induce this behavior in health-care workers. The aim of the present work was to point out the importance of hand bacteria colonization, the influence of hand washing and of patient physical examination. One hundred health-care workers were randomly divided in two groups: Group A without hand washing previous to patient physical examination or handling (PPE); group B with hand washing previous to PPE. Direct fingerprint samples in Columbia agar before and after PPE were obtained. The colonies were counted and identified by conventional techniques, and antibiograms according to NCCLS were performed. Before PPE group A participants showed a high number of bacteria regarding group B participants (73.9 Vs 20.7; p < 0.001); 44 out of 50 participants were carriers of potentially pathogen bacteria. No group B participants were carriers of potential pathogen bacteria before PPE. The latter group showed an increase in number of bacteria after PPE (20.7 CFU (before) Vs 115.9 CFU (after); p < 0.001). Sixteen group B participants were contaminated after PPE with potential pathogens such as S. aureus (50% of them methicillin resistant); Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis, half of them multiresistant. We can conclude on the importance of these results to implement educational programs and to provide the health-care workers with the proper commodities to fulfill this practice.

Myths and Legends in Orthopaedic Practice: Are We All Guilty?

“…Tangential support to this argument can be gleaned from the literature [11,29,34,43,70,75,84,87,89,92,100,104,125]. The hands of physicians are a known link in the transmission of nosocomial pathogens [70].…”

“…The hands of physicians are a known link in the transmission of nosocomial pathogens [70]. In the absence of gloves, there is a considerable increase in bacterial contamination of healthcare workers' hands after patient contact [75,87,100]. Numerous studies have investigated the rates of hand contamination after patient care, and hand contamination may occur even if gloves are worn [11,29,34,43,75,84,87,92,101,125].…”

“…High bacterial colony counts are present on the hands even before patient contact, and these bacteria are frequently potential pathogens [87]. Bacteria are present on the hands of most surgeons before the surgical scrub, and it is vitally important that proper hand scrubbing procedures are followed [25,89,118].…”

Avaliação da técnica de lavagem das mãos executada por alunos do curso de graduação em enfermagem

“…A cada vez que se aumentam os números de infecções hospitalares em uma instituição de saúde, surge a dúvida se a mesma está sendo executada corretamente, pois na literatura encontra-se uma alta freqüência de não execução ou execução inadequada desta técnica pelos profissionais de saúde (33)(34)(35)(36)(37)(38)(39)(40)(41) .…”

Estratégia multimodal na promoção da higiene das mãos: atributos para aceitação e tolerância das preparações alcoólicas

“…A falta de rigor com as práticas de controle de infecção, principalmente no que se refere à adesão a HM, tem sido demonstrada em diversos estudos, que relatam taxas de adesão inferiores a 60% em diferentes realidades de assistência à saúde (O'BOYLE, HENLY, LARSON, 2001;GOPAL et al, 2002;HARBARTH et al, 2002;HUGONNET, PERNEGER, PITTET, 2002;PITTET, 2005;WHITBY et al, 2007;HASS, LARSON, 2008;RUEF, 2009;CAMARGO et al, 2009;ATIF et al, 2009;HOMSTED, 2009;HAKKO et al, 2011 (LARSON, 1999;NOGUERAS et al, 2001;CDC, 2002;ELLIOT, 1992 (SETO, 1995;LEVIN, 1999;GODIN et al, 2000;GIROU et al, 2008;BRAUN, KUSEK, LARSON, 2009;FERREIRA et al, 2009;HOWARD et al, 2009;ROCHA et al, 2009;TENÍAS et al, 2009;HAKKO et al, 2011 A adesão ao procedimento de HM em estabelecimentos de assistência à saúde é um problema que merece ser analisado do ponto de vista individual e organizacional. Deste modo, romper com as dificuldades de adesão à HM é um desafio emergente, e apesar da expressiva evolução tecnológica ainda não se ultrapassou a etapa inicial da conscientização pessoal e organizacional quanto à efetividade desta prática nos cenários de assistência (SETO, 1995;LEVIN, 1999;GODIN et al,2000;LARSON et al, 2000;O'BOYLE, HENLY, LARSON, 2001;GOPAL et al, 2002;PITTET, 2005;WHITBY et al, 2007;GIROU et al, 2008;…”