A new study finds nearly one in four healthcare workers' hands were contaminated with Clostridium difficile spores after routine care of patients infected with the bacteria. The study was published in the January issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
"This is the first known study focusing on the carriage of viable C. difficile spores on healthcare workers hands," said Caroline Landelle, PharmD, PhD, lead author of the study. "Because C. difficile spores are so resistant and persistent to disinfection, glove use is not an absolute barrier against the contamination of healthcare workers' hands. Effective hand hygiene should be performed, even in non-outbreak settings."
Researchers compared hand contamination rates among healthcare workers caring for patients with C. difficile with healthcare workers caring for non-colonized patients after routine patient care and before hand hygiene. All patients with C. difficile were being treated with infection control measures that consisted of (1) placing patients into a single-bed room with dedicated equipment; (2) wearing disposable gowns with full-length sleeves and a pair of gloves on entering the room; (3) hand hygiene with alcohol-based hand rub before wearing gloves, before and after body fluid exposure, and hand washing with medicated soap and water followed by use of alcohol-based hand rub after glove removal; and (4) daily room cleaning with a hypochlorite-based disinfectant.
Contamination of healthcare workers' hands occurred with high-risk contact (e.g., patient washing, digital rectal exam, bed linen change, colonoscopy) or when workers didn't use gloves. Hand contamination was also associated with the duration of high-risk contact and was more common among nursing assistants (42 percent) than among other healthcare workers (19 percent for nurses and 23 percent for physicians), likely because nursing assistants had more high-risk contact.