Environmental contamination by bacteria in hospital washrooms according to hand-drying method: a multi-centre study

Best, E., |2018|  Environmental contamination by bacteria in hospital washrooms according to hand-drying method: a multi-centre study|  Journal of Hospital Infection| 100| 4| P. 469-475.

A new article in the Journal of Hospital Infection considers the importance of hand- drying, it is the largest study of its type to examine whether hand-drying method, in healthcare settings, affects the extent of environmental contamination by potential bacterial pathogens. 

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Summary

Background

Hand hygiene is a fundamental component of infection prevention, but few studies have examined whether hand-drying method affects the risk of dissemination of potential pathogens.

Aim

To perform a multi-centre, internal-crossover study comparing bacterial contamination levels in washrooms with hand-drying by either paper towels (PT) or jet air dryer (JAD; Dyson).

Methods

A total of 120 sampling sessions occurred over 12 weeks in each of three hospitals (UK, France, Italy). Bacteria were cultured from air, multiple surfaces, and dust. Washroom footfall (patients/visitors/staff) was monitored externally.

Findings

Footfall was nine times higher in UK washrooms. Bacterial contamination was lower in PT versus JAD washrooms; contamination was similar in France and the UK, but markedly lower in Italian washrooms. Total bacterial recovery was significantly greater from JAD versus PT dispenser surfaces at all sites. In the UK and France, significantly more bacteria were recovered from JAD washroom floors (median: 24 vs 191 cfu, P less than 0.00001). UK meticillin-susceptible Staphylococcus aureus recovery was three times more frequent and six-fold higher for JAD vs PT surfaces (both P less than  0.0001). UK meticillin-resistant S. aureus recovery was three times more frequent (21 vs 7 cfu) from JAD versus PT surfaces or floors. Significantly more enterococci and extended-spectrum β-lactamase (ESBL)-producing bacteria were recovered from UK JAD versus PT washroom floors (P less than 0.0001). In France, ESBL-producing bacteria were recovered from dust twice as often during JAD versus PT use.

Conclusion

Multiple examples of significant differences in surface bacterial contamination, including by faecal and antibiotic-resistant bacteria, were observed, with higher levels in JAD versus PT washrooms. Hand-drying method affects the risk of (airborne) dissemination of bacteria in real-world settings.

Read the full article at the Journal of Hospital Infection or download 

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