Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Department of Laboratory Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Centre and Seoul National University College of Medicine, Seoul, South Korea.
J Hosp Infect. 2023 May;135:171-178. doi: 10.1016/j.jhin.2023.01.025. Epub 2023 Mar 17.
Disinfection of gloves might reduce the workload of healthcare workers, protect the environment, and bring economic benefits. Thus, the safety of hand hygiene of gloved hands is an important issue.
We aimed to evaluate the risk of microbial transmission by comparing residual micro-organisms after multiple patient contacts, with or without gloves, in clinical practice.
Researchers, two with gloved hands (single or double gloves) and one with bare hands, made rounds of patients, followed by alcohol-based hand rub. Hand imprints were obtained before and after the rounds and cultured. The number of colony-forming units (cfu) of gloved and bare hands was compared, and the colony distribution was evaluated semi-quantitatively by hand region.
A total of 108 imprints were obtained after 10 rounds. The median cfu counts were significantly higher in the gloved hands (single and double) than in the bare hands (9.00 vs 3.50, P=0.028). The cfu counts of single- and double-gloved hands were higher after than before contact (P=0.044 and P=0.001, respectively). Carbapenem-resistant Acinetobacter baumannii was identified in a pair of double gloves after a round, which included patients with the same organism with identical antibiotic susceptibility results. The mean percentage of colony-growing compartments from gloved hands was significantly higher than that of bare hands in the finger and wrist regions (P=0.019 and P=0.049, respectively). Compared with bare hands, reuse of gloves increased residual microbial colonies and potential for transmission of multi-drug-resistant organisms, even after using alcohol-based hand rub.
手套消毒可以减轻医护人员的工作量,保护环境,带来经济效益。因此,戴手套的手卫生安全性是一个重要问题。
我们旨在通过比较有或没有手套的情况下,在临床实践中多次接触患者后残留的微生物,来评估微生物传播的风险。
研究人员,两名戴手套(单层或双层手套),一名戴裸手,对患者进行查房,然后用酒精基手消毒剂进行消毒。查房前后分别进行手部印迹培养。比较戴手套和裸手的菌落形成单位(cfu)数量,并对手部区域进行半定量的菌落分布评估。
共获得 10 轮后 108 个印迹。与裸手相比,手套(单层和双层)的 cfu 计数明显更高(9.00 比 3.50,P=0.028)。与接触前相比,单层和双层手套接触后的 cfu 计数更高(P=0.044 和 P=0.001)。在一轮接触中,包括了携带相同耐药菌的相同抗生素药敏结果的患者,一对双层手套中鉴定出了耐碳青霉烯鲍曼不动杆菌。从戴手套的手的菌落生长区的平均百分比明显高于裸手的手指和手腕区域(P=0.019 和 P=0.049)。与裸手相比,即使使用了酒精基手消毒剂,重复使用手套也会增加残留的微生物菌落和传播多重耐药菌的可能性。