Assessment of Bacterial Transfer From Patient to Chiropractor During Spinal Manipulation

This study aimed to measure the amount of bacteria that may be transferred from patient to chiropractor during spinal manipulation and the efficacy of decontaminants commonly used by chiropractic practitioners.

We chose Kwazulu-Natal, South Africa as the location, which is an area with an increased burden of immunocompromised patients resulting from HIV and tuberculosis. In this region, we obtained samples from 40 chiropractors' hands before and after spinal manipulation. Viable counts of colony-forming units were enumerated to verify the presence of bacteria. A modified Kirby-Bauer technique was used to ascertain the efficacy of the top 5 decontaminants used by chiropractors in this area against the bacteria isolated from their hands.

Both normal microflora and potentially pathogenic bacteria were found. These included Staphylococcus spp., Micrococcus spp., Bacillus spp., Pseudomonas spp., Escherichia coli, Streptococcus spp., and Staphylococcus aureus. Higher bacterial counts were found on chiropractors' hands after patient contact for spinal manipulation, which are similar to findings from studies of other healthcare personnel. The 5 commonly used disinfectants tested in a lab setting were not as effective against bacterial samples when compared with an antimicrobial pharmaceutical medication.

The net transfer of bacteria to chiropractors' hands from the patient to the practitioner during spinal manipulation included primary and opportunistic pathogens. The detergents commonly used by chiropractors in this region showed varying efficacies against microbial growth when tested in vitro.