Monitoring of Frequency and Antimicrobial Susceptibility of Pathogens on the Hands of Healthcare Workers in a Tertiary Hospital.

Abstract

To monitor microbes, focusing on drug resistance, on the hands of the personnel of four departments of a tertiary hospital (ICU, neonatal unit, internal medicine ward and surgical ward) and explore differences between departments, professions and genders. Hand sampling from 125 healthcare employees was conducted followed by isolation, identification and antibiotic resistance profiling of different microbial species. Staphylococcus spp was the most prevalent microbe (76/125, 60.8%), followed by different Gram-negative pathogens (45.6%). ICU employees had a significant probability to have Gram-negative contamination [OR 3.627 (95% CI 1.220-10.782)], independently of gender or profession. Staphylococcus spp presence was associated with working in the internal medicine ward [OR 6.976 (95% CI 1.767-25.540)] and the surgical ward [OR 5.795 (95% CI 1.586-21.178)]. Staphylococcus spp was more prevalent in males vs. females (81.3% vs. 54.9%, p=0.008) and in medical vs. nursing personnel (76.9% vs. 54.8, p=0.019). In the majority of Gram-negative isolates (56.1%), at least one multi-drug resistant (MDR) or extensively drug resistant (XDR) strain was isolated. A statistically significant higher prevalence of XDR Gram-negative microbes was found on the hands of nursing personnel (22.2% vs. 2.3% for medical doctors, p=0.014). Only 2 methicillin resistant Staphylococcus Aureus (MRSA) out of the 12 Staphylococcus aureus positive samples were identified. Employees in the ICU are more prone to Gram-negative and not to Gram-positive hand contamination. MDR and XDR pathogens are prevalent, and are associated with nursing profession.