Publication:

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

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.