Persistent carriage of gram-negative bacteria on hands

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Hospital Epidemiology

Background:

• Gram-negative bacteria (GNB) are a significant cause of nosocomial infections.
• The prevalence of GNB on the hands of healthcare personnel and the general population is not well-established.
• Understanding GNB hand carriage is crucial for infection control strategies.

Purpose of the Study:

• To investigate the prevalence and species of GNB carried on the hands of hospital personnel and controls.
• To identify risk factors associated with persistent GNB hand carriage.
• To determine the contribution of hand GNB to nosocomial infections.

Main Methods:

• Hand flora of 103 hospital personnel and 50 controls were sampled over 35 days.
• Prevalence of GNB carriage, species identification, and risk factors (gender, handwashing frequency) were analyzed.
• Correlation between hand GNB and nosocomial infections was assessed.

Main Results:

• Persistent GNB carriage was found in 21% of hospital personnel and 80% of controls (RR 3.2).
• Males and individuals washing hands <8 times/day showed higher GNB carriage rates.
• Acinetobacter and Klebsiella-Enterobacter were the predominant GNB species.

Conclusions:

• Gram-negative bacteria are more prevalent on normal skin than previously thought.
• Handwashing is effective in reducing GNB carriage without altering the skin's microbial balance.
• Hospital hand hygiene practices contribute to reducing GNB-related nosocomial infections.