Occurrence of potentially pathogenic bacteria on the hands of hospital patients before and after the introduction of patient hand disinfection

The leading cause of nosocomial infections and spread of multiresistant bacteria is considered to be the failure of healthcare workers to perform appropriate hand hygiene. The role of the hands of hospital patients in the spread of infection has received little attention. The aim of the present study was to investigate the occurrence of potentially pathogenic bacteria on the patients' hands. Quantitative cultures were repeatedly taken from the fingertips of patients at a rehabilitation clinic before and after an intervention in which patient hand disinfection was introduced and promoted. Before the intervention, the occurrence on the hands of Escherichia coli, Klebsiella spp., enterococci, Staphylococcus aureus and yeast was a common finding. The colony counts of S. aureus were often higher than the counts of other organisms. After the intervention, the level of hand contamination was lower. The difference was statistically significant (p < 0.05) concerning Enterobacteriaceae, both when the patients were resting and at lunch time, for enterococci and total bacterial counts at lunch time, and for yeast when they were resting. Concerning S. aureus, the difference was not statistically significant, neither while resting nor at lunch time. The role of the patients in the spread of pathogenic bacteria merits more discussion.