A study on the bio-burden of doctors' and other health care workers' hands, stethoscopes and other medical devices in a Sri Lankan set up - Potential risk of nosocomial infections?

Abstract

OBJECTIVE: To assess the potential risk of nosocomial infection DESIGN: Descriptive, prospective controlled study over a period of 17 days in November 2002. SETTING: Special care baby unit, labour room, surgical wards 1 and 2. theatre and the intensive care unit of the Teaching Hospital, Ragama. METHODS: Thirty hand imprints including 13 doctors, 17 other health care workers and 85 swabs from 6 stethescopes and 31 medical equipment were taken randomly. Six health care workers and 3 stethoscopes were included for a control study. Cultures were identified and antibiotic sensitivity tests were performed. RESULTS: 97% (29/30) of hand imprints were contaminated. The main pathogen isolated was Staphylococcus aureus (43%). 60% of Staphylococcus aureus strains were methicillin resistant (MRSA) and 33% of MRS A were also resistant to Vancomycin. Vancomycin resistance needs confirmation. There were Klebsiella spp, E. coli and other coliforms in 27%, Pseudomonas spp in 13% and Candida spp in 3%. 73 % (51/85) of equipment were contaminated. There were Staphylococcus aureus in 29%, E. coli, Klebsiella species and other coliforms in 22%, Pseudomonas species in 13%, arid Candida species in 1%. Of the stethescopes. 33% of bells and diaphragms had Staphylococcus aureus. There was complete elimination of organisms from both hands and stethoscopes of the control following the useof4%hibitane CONCLUSION: This study clearly demonstrates the burden of bacterial contamination among hands of healthcare workers in Sri Lanka.