Pathogens on the Hands of Hospitalized Patients
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Date
2017-05
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The Ohio State University
Abstract
Hand hygiene is recognized as the most important measure to prevent the transmission of infection. Despite evidence that infections can be transferred from contact with a patient’s skin or the environment, little research has been directed toward patient-centered hand hygiene. The purpose of this study is to analyze the relationship between patient characteristics and the presence of pathogens on patients’ hands.
This cross-sectional, observational study collected bacterial samples and demographic data from 22 adult medical-surgical patients at The Ohio State University Wexner Medical Center East. Bacteria were collected using glove juice sampling procedures. Samples were then serially diluted, plated, and incubated. Aerobic colonies were counted using standard counting procedures and were statistically analyzed. Pathogen specific confirmation was performed using appropriate confirmatory tests, such as gram staining and selective media. Patient demographic data, such as sex, age, ethnicity, length of stay, admitting diagnosis, and isolation precautions, were abstracted from the electronic health record. The relationship between patient data and bacterial presence was analyzed using chi-squared tests.
Results show that 86% (19/22) of patients were positive for S. aureus, 36% (8/22) were positive for MRSA, 86% (19/22) were positive for C. difficile, 24% (5/21) were positive for C. difficile using UV light analysis, and 30% (4/13) were positive for VRE. The average number of colony forming units per mL of solution was 8.59 x 102.
An increased length of stay was not associated with an increased bacterial load. There was no relationship between infectious diagnosis or isolation precautions and bacterial load. A lack of association between patient characteristics and bacterial load may be due to a lack of long-term follow-up with patients and a small sample size.
The results of this study suggest that a high percentage of patients’ hands are positive for infectious organisms such as S. aureus, MRSA, C. difficile, and/or VRE. Patient hand hygiene protocols could decrease the transmission of infection, resulting in better patient outcomes and a decrease in healthcare costs.
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Keywords
hand hygiene, infectious disease, patient-centered care, healthcare-associated infections