COMPARISON OF BACTERIAL FLORA ON THE HANDS OF HEALTHCARE WORKERS AND NON-HEALTHCARE WORKERS

ABSTRACT

The hands serve as reservoirs of microbial flora hence play an important role in infection transfer. This project work was carried out to demonstrate and compare the bacterial flora on the hands of health care workers (HCW) and non-health care workers (NHCW), their antibiotic susceptibility pattern and the efficacy of SmartansTM alcohol based hand sanitizer (ABHS) in hand hygiene. The samples were collected twice in sterile polyethylene bags before and after the use of hand sanitizer, plated on MacConkey agar, Nutrient agar and Blood agar after serial dilution within 5 hours of collection and incubated for 24 hours. Antibiotic susceptibility pattern of the isolates was tested. Probable organisms isolated include Coliforms, Staphylococcus sp and Pseudomonas sp. A students t-test was used to analyze the mean heterotrophic count of the isolates (p>0.05). Amongst the isolates, Escherichia coli was the most prevalent in both HCW and NHCW. The least occurring specie on NHCW was Proteus sp whereas there was no growth of Enterobacter sp recorded for HCW. Although exposure to environmental flora is important in developing a natural immune system, proper hand hygiene practice with the use of hand sanitizers is one of the ways to curb the prevalence of bacterial flora that could be of major clinical significance.

TABLE OF CONTENTS

Title page ﾿

Certification ﾿ i

Dedication ﾿ ii

Acknowledgement ﾿ iii

Table of Contents ﾿ iv

List of Tables ﾿ v

List of Figures ﾿ vi

Abstract ﾿ vii

CHAPTER ONE

1.1 ﾿ INTRODUCTION ﾿ 1

1.2 ﾿ Aim ﾿ 2

1.3 ﾿ Objectives ﾿ 2

CHAPTER TWO

LITERATURE REVIEW ﾿ 3

2.1 ﾿ Historical view of hand hygiene ﾿ 3

2.2 ﾿ The hand: a vector ﾿ 4

2.3       Choice for hand hygiene agents ﾿ 5

2.4       Agents commonly used for hand hygiene ﾿ 6

2.5       Interaction between hand hygiene products ﾿ 13

2.6       Dispensing of hand hygiene products ﾿ 13

2.7       Effective hand hygiene techniques ﾿ 14

2.8       Alcohol-based hand rubs ﾿ 14

2.9       Handwashing ﾿ 15

2.10     Hand wipes ﾿ 16

2.11     Drying methods ﾿ 17

2.12     Barriers to effective hand hygiene ﾿ 17

2.12.1 ﾿ Natural fingernails and nail enhancements as barriers to effective 

hand hygiene ﾿ 19

2.12.2 ﾿ Jewellery as a barrier to effective hand hygiene ﾿ 20

2.12.3 ﾿ Other barriers to effective hand hygiene ﾿ 21

2.13     Compliance to hand hygiene ﾿ 21

CHAPTER THREE

3.1 ﾿ MATERIALS AND METHODS ﾿ 25

3.2 ﾿ Bacteriological analysis ﾿ 25

3.3      ﾿ Antibiotic susceptibility ﾿ 26

3.4      ﾿ Biochemical testing ﾿ 27

3.5 ﾿ Data analysis ﾿ 28

CHAPTER FOUR

RESULT ﾿ 29

CHAPTER 5 ﾿

5.1 ﾿ Discussion ﾿ 36 ﾿

5.2 ﾿ Conclusion ﾿ 37

5.3 ﾿ Recommendation ﾿ 37

REFERENCES ﾿ 39

LIST OF TABLES

Tables ﾿             Title ﾿ Page ﾿

1 ﾿ Identification and characteristics of isolated organisms ﾿ 31

2 ﾿ Prevalence of isolates in CFU/G before the use of hand sanitizer ﾿ 33

3 ﾿ Prevalence of isolates in CFU/g after the use of hand sanitizer ﾿ 34

4 ﾿ Antibiotic susceptibility of isolates from hands of NHCW ﾿ 35

5 ﾿ Antibiotic susceptibility of isolates from hands of HCW ﾿ 36

LIST OF FIGURE

Figure ﾿ Title ﾿ Page

1 ﾿ Frequency of occurrence of isolates from hands of HCW and NHCW ﾿ 32