BACTERIAL CONTAMINATION OF HANDS OF MEDICAL INTERNS AND UNDERGRADUATE STUDENTS

Sunandha Senthil; Ashwini Hegde; Vaman Kulkarni; Radhakrishna M

doi:10.22159/ajpcr.2017.v10i12.20908

Authors

Sunandha Senthil Department of Microbiology, Kasturba Medical College, Mangalore, Manipal University, Karnataka, India.
Ashwini Hegde Department of Microbiology, Kasturba Medical College, Mangalore, Manipal University, Karnataka, India.
Vaman Kulkarni Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal University, Karnataka, India.
Radhakrishna M Department of Microbiology, Kasturba Medical College, Mangalore, Manipal University, Karnataka, India.

DOI:

https://doi.org/10.22159/ajpcr.2017.v10i12.20908

Keywords:

Bacterial contamination, Hands, Medical interns, Undergraduates

Abstract

Objective: Cross-transmission by the hands of health-care workers is considered the main route of spread of nosocomial infections. Awareness among medical students and interns about the importance of hand hygiene practices and facilities for its adherence can play a major role in reducing disease transmission. The objectives of the present study were: (1) To determine the level and type of microbial contamination present on the hands of medical students and interns from a teaching hospital of Mangalore, Karnataka, and (2) to evaluate the relationship between hand contamination and knowledge, attitude, and practices of hand hygiene.

Methods: Swabs were obtained from the dominant hand and the skin surface beneath the rings of participants during their routine work hours. Laboratory analysis was carried out within one hour of collection of samples. The participants were asked to fill a questionnaire on hand hygiene. Descriptive statistics and analysis was done by Chi-square test.

Results: Of the 70 study participants, 35 (50%) were medical undergraduate students and 35 (50%) were medical interns. The contamination rate was higher among the undergraduates (91.4% [32/35]) compared to interns (77.1% [27/35]). 38 (54%) participants hands were contaminated with Staphylococcus aureus, of which 17 (44.7%) were methicillin-resistant S. aureus. Although overall knowledge status about hand hygiene was good, concepts about certain key elements in hand hygiene were not clearly understood by the participants. Knowledge about alcohol-based hand rubs was not up to the mark. The level of knowledge was found to be similar between UGs and interns and between the genders. Wearing ring while handling patients had an influence on hand contamination.

Conclusions: Although the overall knowledge about hand hygiene was good, very few participants knew that hand hygiene after exposure to immediate surroundings of patient can prevent cross-transmission. Health-care workers may unknowingly carry antibiotic-resistant bacteria on their hands. Being unaware of this fact may have serious repercussions as the students and interns may serve as a medium for the spread of nosocomial infections.

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Author Biography

Radhakrishna M, Department of Microbiology, Kasturba Medical College, Mangalore, Manipal University, Karnataka, India.

Associate Professor and Consultant Microbiologist

Department of Microbiology

References

Saloojee H, Steenhoff A. The health professionalâ€™s role in preventing nosocomial infections. Postgrad Med J 2001;77(903):16-9.

Kampf G, LÃ¶ffler H, Gastmeier P. Hand hygiene for the prevention of nosocomial infections. Dtsch Arztebl Int 2009;106(40):649-55.

Gunasekara A, Kottahachchi WJ, Fernando W. Knowledge, attitudes and practices of hand hygiene among final year medical and nursing students at the University of Sri Jayewardenepura. Sri Lankan J Infect Dis 2013;3(1):15-25.

Nair SS, Hanumantappa R, Hiremath SG, Siraj MA, Raghunath P. Knowledge, attitude, and practice of hand hygiene among medical and nursing students at a tertiary health care centre in Raichur, India. ISRN

Prev Med 2014;2014:608927.

Khodavaisy S, Nabili M, Davari B, Vahedi M. Evaluation of bacterial and fungal contamination in the health care workersâ€™ hands and rings in the intensive care unit. J Prev Med Hyg 2011;52(4):215-8.

Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: A meta-analysis. Clin Infect Dis 2003;36(1):53-9.

Pelz RK, Lipsett PA, Swoboda SM, Diener-West M, Powe NR, Brower RG, et al. Vancomycin-sensitive and vancomycin-resistant enterococcal infections in the ICU: Attributable costs and outcomes. Intensive Care Med 2002;28(1):692-7.

Ken I, Jayshree D, Alison P. Nosocomial infections. Contin Educ Anaesth Crit Care Pain 2005;5(1):14-7.

Feather A, Stone SP, Wessier A, Boursicot KA, Pratt C. Now please wash your hands: The handwashing behaviour of final MBBS candidates. J Hosp Infect 2000;45(1):62-4.

Wolfensberger A, Durisch N, Mertin J, Ajdler-Schaeffler E, Sax H. Evaluating the tolerability and acceptability of an alcohol-based hand rub - Real-life experience with the WHO protocol. Antimicrob Resist Infect Control 2015;4:18.

Graf M, Machado A, Mensor L, Zampieri D, Campos R. Surgical hands antisepsis with alcohol based preparations: Cost effectiveness, compliance of professionals and ecological benefits in the Brazilian healthcare scenario. Antimicrob Resist Infect Control 2015;4(1):162-7.

van De Mortel TF, Kermode S, Progano T, Sansoni J. A comparison of the hand hygiene knowledge, beliefs and practices of Italian nursing and medical students. J Adv Nurs 2012;68(3):569-79.

Cook HA, Cimiotti JP, Della-Latta P, Saiman L, Larson EL. Antimicrobial resistance patterns of colonizing flora on nursesâ€™ hands in the neonatal intensive care unit. Am J Infect Control 2007;35(4):231-6.

Salisbury DM, Hutfilz P, Treen LM, Bollin GE, Gautam S. The effect of rings on microbial load of health care workersâ€™ hands. Am J Infect Control 1997;25(1):24-7.

Cheesbrough M. District laboratory practice in Tropical Countries - Part 2. Cambridge, UK: Cambridge University Press; 2005.

Paul R, Das NK, Dutta R, Bandyopadhyay R, Banerjee AK. Bacterial contamination of the hands of doctors: A study in the medicine and dermatology wards. Indian J Dermatol Venereol Leprol 2011;77(3):307-13.

Al Kadi A, Salati SA. Hand hygiene practices among medical students. Interdiscip Perspect Infect Dis 2012;2012:679129.

Graf K, Chaberny IF, Vonberg RP. Beliefs about hand hygiene: A survey in medical students in their first clinical year. Am J Infect Control 2011;39(10):885-8.

Herbert VG, Schlumm P, Kessler HH, Frings A. Knowledge of and Adherence to hygiene guidelines among medical students in Austria. Interdiscip Perspect Infect Dis 2013;2013:802930.

Trick WE, Vernon MO, Hayes RA, Nathan C, Rice TW, Peterson BJ, et al. Impact of ring wearing on hand contamination and comparison of hand hygiene agents in a hospital. Clin Infect Dis 2003;36(1):1383-90.

Adams BG, Marrie TJ. Hand carriage of aerobic Gram-negative rods by health care personnel. J Hyg (Lond) 1982;89(1):23-1.

Green BN, Johnson CD, Egan JT, Rosenthal M, Griffith EA, Evans MW. Methicillin-resistant Staphylococcus aureus: An overview for manual therapists (). J Chiropr Med 2012;11(1):64-76.

Hamilton-Miller JM, Iliffe A. Antimicrobial resistance in coagulase-negative staphylococci. J Med Microbiol 1985;19(2):217-6.

Mann CM, Wood A. How much do medical students know about infection control? J Hosp Infect 2006;64(4):366-70.

Girou E, Loyeau S, Legrand P, Oppein F, Brun-Buisson C. Efficacy of hand rubbing with alcohol based solution versus standard hand washing with antiseptic soap: Randomised clinical trial. BMJ 2002;325(7360):362.

Naeem A, Saluja SA, Krishna D, Shitanshu M, Arun S, Taseer B. Contamination of dentistâ€™s hands with and without finger rings. J Int Oral Health 2015;7(8):114-7.