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Dynamics of Bacterial Hand Contamination During Routine Neonatal Care

Published online by Cambridge University Press:  02 January 2015

Carmem Lúcia Pessoa-Silva ,
Sasi Dharan ,
Stéphane Hugonnet ,
Sylvie Touveneau ,
Klara Posfay-Barbe ,
Riccardo Pfister  and
Didier Pittet
Carmem Lúcia Pessoa-Silva
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
Sasi Dharan
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
Stéphane Hugonnet
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
Sylvie Touveneau
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
Klara Posfay-Barbe
Affiliation:
Department of Pediatrics, University of Geneva Hospitals, Geneva, Switzerland
Riccardo Pfister
Affiliation:
Department of Pediatrics, University of Geneva Hospitals, Geneva, Switzerland
Didier Pittet*
Affiliation:
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland
*
Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland
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Abstract

Objective:

To evaluate the dynamics of bacterial contamination of healthcare workers' (HCWs) hands during neonatal care.

Setting:

The 20-bed neonatal unit of a large acute care teaching hospital in Geneva, Switzerland.

Methods:

Structured observation sessions were conducted. A sequence of care began when the HCW performed hand hygiene and ended when the activity changed or hand hygiene was performed again. Alcohol-based handrub was the standard procedure for hand hygiene. An imprint of the five fingertips of the dominant hand was obtained before and after hand hygiene and at the end of a sequence of care. Regression methods were used to model the final bacterial count according to the type and duration of care and the use of gloves.

Results:

One hundred forty-nine sequences of care were observed. Commensal skin flora comprised 72.4% of all culture-positive specimens (n = 360). Other microorganisms identified were Enterobacteriaceae (n = 55, 13.8%); Staphylococcus aureus (n = 10, 2.5%); and fungi (n = 7,1.8%). Skin contact, respiratory care, and diaper change were independently associated with an increased bacterial count; the use of gloves did not fully protect HCWs' hands from bacterial contamination.

Conclusions:

These data confirm that hands become progressively contaminated with commensal flora and potential pathogens during neonatal care, and identify activities at higher risk for hand contamination. They also reinforce the need for hand hygiene after a sequence of care, before starting a different task, and after glove removal.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 3 , March 2004 , pp. 192 - 197
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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