Bacterial Contamination of Paper-Towel Dispensers in Healthcare Settings: A Cross-Sectional Environmental...

/Purpose: Environmental surfaces that interface with hand hygiene may serve as underrecognized sites of microbial contamination. Paper-towel dispensers are frequently used but are often excluded from routine cleaning and surveillance. This study aimed to assess the prevalence and burden of bacterial contamination on paper-towel dispensers, compare contamination between manual and touch-free units, and characterize recovered organisms.

We conducted a cross-sectional environmental surveillance study at a tertiary care hospital, sampling 40 paper-towel dispensers (30 manual, 10 touch-free) in public and staff bathrooms, hallway sinks, public kitchenette/nutrition station areas, and break areas. Dispenser apertures were swabbed using premoistened ESwabs. Samples were cultured on blood agar and assessed semi-quantitatively. Organisms were identified via MALDI-TOF. Contamination prevalence and CFU burden were compared between dispenser types using Fisher's exact and Mann-Whitney U tests.

Surveillance cultures identified bacterial contamination in 70% (28/40) of paper-towel dispensers. Contamination was more frequent among manual dispensers than touch-free dispensers (80% vs. 40%; relative risk 2.0, 95% confidence interval 0.92-4.36; Fisher's exact test, P=0.04). The most commonly recovered organisms were Bacillus spp. and Coagulase-negative staphylococci. Organisms of clinical or IPC concern were identified in 14% of dispensers, with most located in the emergency department. No multidrug-resistant organisms were detected.

Although the findings should be interpreted with caution given the wide confidence interval and exploratory design of the analysis, they indicate that paper-towel dispensers may harbor bacterial contamination at the hand hygiene interface. These observations may guide future environmental hygiene policies and the development of targeted infection prevention interventions in healthcare settings.