Hand Hygiene Practices, Attitudes, and Microbial Hand Populations of Practicing Doctors of Chiropractic

Hand hygiene practice is important in health care settings to reduce the spread of infection. To date, no hand hygiene study has been conducted with doctors of chiropractic that included microbiological analysis of hand specimens. The primary objective of this study was to examine the relationship between self-reported hand hygiene practices and attitudes of chiropractors with the number and type of pathogenic bacteria and yeast present on their hands.

In this cross-sectional study, a microbiological analysis of the chiropractor's dominant hand was performed along with completion of a survey concerning practices and attitudes regarding hand hygiene. The relationship between self-reported measures with laboratory findings was conducted using generalized linear modeling.

Participants who responded to the survey indicated that hand hygiene was important, and most reported performing hand hygiene before and/or after patient contact. However, 7 (26.9%) participants had multidrug-resistant bacteria isolated from their hands. There was no correlation between the survey responses and hand specimens with the exception of the number of handwashing episodes. From the hand specimens, 16 (45.7%) coagulase-negative staphylococci isolates were oxacillin resistant, and 9 (25.7%) were multidrug resistant.

This study found that like other health care workers, chiropractors had antimicrobial-resistant bacteria on their hands, some of which were multidrug resistant. Multidrug resistant bacteria have the potential to be transferred to patients and patient contact surfaces. These findings indicate that chiropractic offices could play a role in health care-associated infections. Formal hand hygiene training should be included as part of the chiropractic education curriculum and continuing education for doctors of chiropractic.