One in Four Healthcare Workers Get Hands Contaminated by Diarrhea-Causing Bacteria

One in four health care workers dealing with patients infected with Clostridium difficile, a bacteria known for causing infectious diarrhea, leaves the patient's room with contaminated hands, even if the workers wore gloves, according to a new study.

The routine care of patients infected with the bacteria C. difficile led to health care workers' hands becoming contaminated with the bacteria spores, even when strict hygiene measures were in place.

"This is the first known study focusing on the carriage of viable C. difficile spores on healthcare workers hands," said Caroline Landelle, 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."

For the study, Landelle and her colleagues compared the contamination rates among healthcare workers caring for patients with C. difficile with healthcare workers caring for other patients. The workers were examined after preforming routine patient care and before hand hygiene.

Every patient in the study that was infected with C. difficile was in a single-bed room with dedicated equipment. Healthcare workers in the rooms were required to wear disposable gloves and full-length disposable gowns upon entering the room. Before putting on gloves, the workers were to sanitize their hands with an alcohol-based solution. The alcohol solution was to be used before and after any exposure to the patients' body fluids, and again after the removal of gloves, but prior to a hand-washing with medicated soap. The patients' rooms were also cleaned daily with disinfectants.

The workers who had to assist infected patients with washing, changing linens or with rectal temperature-taking or colonoscopy were the most likely to get their hands contaminated with C. difficile. Forty-two percent of nursing assistants were found to have contaminated hands after working with a patient infected with C. difficile. Nineteen percent of nurses and 23 percent of physicians also had contaminated hands after treating infected patients.

Dr. Aurora Pop-Vicas, a study co-auther, said "this study offers a vivid insight into why C. difficile might be so stubbornly persistent in our hospital...much work remains to be done in implementing what is known about the prevention of the spread of this bacteria through horizontal transmission. Additional measures include improvement in antimicrobial stewardship programs and effective environmental cleaning within healthcare institutions."

The study authors suggest that hospital workers may be unintentionally spreading C. difficile to other patients and healthcare staff. In dealing with patients infected with C. difficile, the researchers recommend healthcare workers do more hand-washing with soap and water, rather than using alcohol-based hand sanitizers.

The research is published in the journal Infection Control and Hospital Epidemiology.