Microbial contamination of hands of healthcare providers in the operating theatre of a central hospital

Abstract

Background

Effort is invested in maintaining sterility of the operating field, but less attention is paid to potential healthcare associated infection (HAIs) sources through patient contact by non-scrubbed healthcare providers (HCPs). A single microbiological assessment of hands can provide a good assessment of the potential dynamic transmission of microorganisms. The aim of this study was to identify and quantify the microbial growth on the hands of HCPs in the operating theatres of Chris Hani Baragwanath Academic Hospital.

Methods

A prospective, contextual and descriptive study design was followed. Seventy-five samples were collected using convenience sampling from an equal number of surgeons, anaesthetists and nurses. Specimens were taken using agar platesand underwent semi-quantitative analysis.

Results

All hands of HCPs displayed growth, of which 82% grew commensals and 80% grew pathogens. Twelve commensal microorganisms and 27 pathological microorganisms were noted. Two or more organisms were cultured on 76% of HCPs’ hands. Comparisons of commensal, pathological and combined levels of contaminationamong the three groups were not statistically significant (p=0.266, p=0.673, p=0.180). There was no significant difference between the growth of combined microorganisms (p=0.927)and pathological microorganisms (p=0.499) among the groups.Surgeons had significantly more commensal growth (p=0.019) than anaesthetists and nurses. There was no statistically significant difference between sexes (p=0.611).

Conclusion

It was concerning that 100% of the hands of HCPs who were about to commence with the surgical list had microbial growth. These HCPs could have already been in contact with patients and equipment in the theatre environment. Microorganisms cultured on hands are a source of cross-transmission which may result in HAIs. Institutions require the implementation of a multidimensional model to amend guidelines, implement guidelines and increase awareness of hand hygiene.