The Investigation And Control Of The Contamination Of Medical Staff’s Hands And High Frequency Contact Surfaces In The Hospital

Objective:Hospital infection has become the important cause of death in hospital patients.The pollution of medical staff’s hands and ward environment is the most important risk factor of hospital infection. This research was to investigate the contamination of the hands of hospital staffs and the high frequency contact surface, to analysis the contamination degree of the hospital staff hand from different types and different departments, different levels of pollution of high frequency contact surfaces. To examine whether bacteria are transferred between the hands of medical staff and high frequency contact surfaces within and between departments and to analyze the patterns of cross-transmission. Put forward measures for the management of medical staff’s hand hygiene so as to strengthen the medical staff’s awareness of the prevention and control of nosocomial infections.Methods:In this prospective study, microbiological samples were collected from the dominant hand of 112 hospital staffs in four departments of our hospital (medical intensive care unit, surgical intensive care unit, urological surgery unit, neurosurgical unit), as well as from 120 high frequency contact surfaces in the same departments on February 20～21,2014. Samples were collected using replicate organism detection and counting (RODAC) method, analyzed by standard microbiology testing and partially genotyped using pulsed-field gel electrophoresis.Results:In 112 specimens of medical personnel hands, the total detection rate was 94.6%. Statistical difference was detected on the number of strains colonies between the nurse and doctors, paramedical personnel (P<0.05), median number of strains colonies from nurse was lowest, while median number of strains colonies from paramedical personnel was highest; Statistical difference was detected on the number of strains colonies on the hands from the four different departments(P<0.05), median number of strains colonies from staffs in medical intensive care unit was lowest, while median number of strains colonies from staffs in neurosurgical unit was highest; In 120 specimens of high frequency contact surface, the total detection rate was 97.5%.Comparing the median number of bacteria colony count from different high frequency contact surface,bacteria colonies from sputum suction tube, bed profile, infusion pump, blood glucose meter, ECG monitor were higher than bacteria colonies from others. Statistical difference was detected on the number of strains colonies on the hands from the four different departments(P<0.05).Median number of bacteria colony count on high frequency contact surface from ICU medical department was highest, while median number of strains colonies from neurosurgical unit was lowest. As we can see from the result of pulsed field gel electrophoresis (PFGE), genetically identical methicillin-sensitive staphylococcus aureus (MSSA) was identified on bedside rail restraint in the medical intensive care unit and on the hands of the nurse in the neurosurgical unit(PFGE pattern:G). Genetically identical meticillin-resistant staphy lococcus aureus (MRSA) was identified both on the surface of a multi-parameter electrocardiography device in surgical intensive care unit and on the surface of another multi-parameter electrocardiography device in the medical intensive care unit(PFGE pattern:J). Genetically similar MSSA was identified on an infusion pump in the medical intensive care unit and on the hands of the doctor in surgical intensive care unit (PFGE pattern:B,B’).Conclusion:Through this study, we found hands of the hospital staffs and high frequency contact surface were widely polluted under the work condition. The most important contribution of this study was that we should pay attention to the high frequency contact surfaces while we focus on hand hygiene. At the same time, we found hands with high levels of pollution:hands of paramedical personnel and workers from neurosurgical unit. We found high frequency contact surfaces from medical intensive care unit was high levels of pollution. Especially surface of sputum suction tube, bed profile, infusion pump, blood glucose meter, ECG monitor were polluted heavier. Cross-contamination of medical workers’hands and contact surfaces with MSSA or has been demonstrated in the same departments. Cross-contamination of contact surfaces with MRSA has been demonstrated between departments. We should pay more attention on the following nursing procedures such as:after using the infusion pump, blood glucose meter, ECG monitor.We should strengthen cleaning and disinfection of these medical equipments and hand hygiene.Improvements are needed in medical staff hygiene habits and in the cleaning of high frequency contact surfaces in order to help prevent and control nosocomial infections.