Microbiological Assessment of the Different Hand Drying Methods and Washroom Environment Cross-Contamination

Proper hand drying is a fundamental part of the hand hygiene process looking at optimizing the elimination of potentially pathogenic microbes. This research compared the effectiveness of three different hand drying methods—paper towels, the use of warm air dryers in stationary hands position, and the use of air drying while hand rubbing—and their potential for cross-contamination of other users and the surrounding environment. One hundred sixty samples were collected from finger pads and palms, before and after drying. The outlet of the air dryers, air current emitted from the air dryers, and washroom environment air were also tested. The study reported that paper towels were more successful in eliminating bacteria and lead to less contamination to the washroom environment compared to the air dryers. The average number of bacteria obtained from volunteers using hand air dryer while hand rubbing was significantly higher than drying with air dryer while holding hands stationary. Plates exposed to the turned-off dryer for 5 minutes gave an average of only 25 colonies/plate, while plates exposed to the air outlet of the turned-on warm air dryers provided 292 colonies/plate. Placing Petri dishes at least one meter away from the dryer in the washroom for 30 minutes gave 72.5 colonies/plate. The current research also documented frequent contamination of public washroom environments and showed dissemination of potential pathogens, including Escherichia coli (E. coli), Klebsiella species, Bacillus cereus (B. cereus), Staphylococcus aureus (S. aureus), and coagulase-negative Staphylococci. Over 70.0% of Staphylococci were resistant to at least three antibiotics and 50.0% revealed coresistance to at least four antibiotics including penicillin, erythromycin, clindamycin, and co-trimoxazole. The method of hand drying may serve as a risk factor of cross-contamination from users to the environment and subsequent users and as reservoirs of drug-resistant bacteria in public washrooms.

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Microbiological evaluation of different hand drying methods for removing bacteria from washed hands

Scientific Reports ◽

10.1038/s41598-019-50239-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Lorna K. P. Suen ◽

Vanessa Y. T. Lung ◽

Maureen V. Boost ◽

Cypher H. Au-Yeung ◽

Gilman K. H. Siu

Keyword(s):

Environmental Sustainability ◽

Multiple Comparisons ◽

Drying Methods ◽

Hand Rubbing ◽

Paper Towel ◽

Significant Difference ◽

Hands On ◽

Air Dryer ◽

Paper Towels ◽

Hand Drying

Abstract Proper drying of hands after washing is an integral part of hand hygiene. An experimental study on 30 subjects using multiple comparisons of six hand drying methods including 1) drying on own clothes, 2) drying with one paper towel, 3) drying with two paper towels, 4) drying with a warm air dryer while holding hands stationary for 20 s, 5) drying with a warm air dryer while hand rubbing for 20 s, and 6) drying with a jet air dryer until complete dryness was achieved. It aimed to determine the effectiveness of different hand drying methods for removing bacteria from washed hands, so as to identify the optimum method using minimum resources. Our study demonstrated that the use of jet air dryers is the best method to eliminate bacteria on hands, whereas drying hands on one’s own clothes is the least effective. Drying hands in a stationary position could remove more bacteria than rubbing hands when using a warm air dryer for 20 s, which mimics people’s usual hand-drying practice. No significant difference in bacteria reduction was detected between the use of one or two paper towels for hand drying; therefore, using fewer resources is recommended to maintain environmental sustainability.

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From the hospital toilet to the ward: A pilot study on microbe dispersal to multiple hospital surfaces following hand drying using a jet air dryer versus paper towels

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.43 ◽

2021 ◽

pp. 1-4

Author(s):

Ines B. Moura ◽

Duncan Ewin ◽

Mark H. Wilcox

Keyword(s):

Pilot Study ◽

Microbial Contamination ◽

Virus Transmission ◽

Hospital Environment ◽

Virus Contamination ◽

Air Dryer ◽

Paper Towels ◽

Hand Drying

Abstract Using a bacteriophage to represent microbial contamination, we investigated virus transmission to the hospital environment following hand drying. The use of paper towels resulted in lower rates of virus contamination on hands and clothing compared with a jet air dryer and, consequently, lower contamination of multiple hospital surfaces.

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The contribution of hand drying in prevention of transmission of microorganisms: Comparison of the efficacy of three hand drying methods in the removal and distribution of microorganisms

Journal of Infection Prevention ◽

10.1177/1757177418789485 ◽

2018 ◽

Vol 19 (6) ◽

pp. 310-317 ◽

Cited By ~ 1

Author(s):

Sarah J Pitt ◽

Samantha L Crockett ◽

Gregory M Andreou

Keyword(s):

Hand Hygiene ◽

Infection Control ◽

Hand Washing ◽

Nutrient Agar ◽

Drying Methods ◽

Opportunistic Pathogens ◽

Colony Forming Units ◽

Public Areas ◽

Paper Towels ◽

Hand Drying

Background: Hand hygiene is a key tool in infection control. While methods of hand washing have been widely researched, there have been fewer studies investigating the effectiveness of available ways to dry hands in public areas. Aims: This study compared the efficacy of using paper towels (PT), warm air dryers (WAD) and jet air dryers (JAD) after hand washing in terms of microbiological effectiveness and potential for dispersal of pathogens. Methods: Microbial flora on palms and fingertips of 30 subjects were sampled on nutrient agar plates before washing hands and after drying with PTs, WADs and JADs. Total colony forming units (cfus) were recorded. Walls in the vicinity of a PT dispenser, WAD and JAD in female and male washrooms were sampled for the presence of viable microorganisms. Results: Mean cfu significantly reduced after drying with PTs (palms t= 2.67, p <0.05; fingertips t=4.44, p<0.01) significantly increased after using WADs (palms t=3.11, p<0.01; fingertips t=2.06, p<0.05), but there was no difference with JAD (palms t= 1.85, p>0.05; fingertips t=0.97, p>0.05). Some dispersal of organisms was detected on the washroom walls, with the least distribution around PT dispensers and unusual opportunistic pathogens isolated from the JAD units. Discussion: PTs are more effective at drying hands than WADs and JADs, they are more likely to be used appropriately and lead to minimal dispersal of microorganisms from wet hands.

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Impact of On-Farm Interventions against CTX-Resistant Escherichia coli on the Contamination of Carcasses before and during an Experimental Slaughter

Antibiotics ◽

10.3390/antibiotics10030228 ◽

2021 ◽

Vol 10 (3) ◽

pp. 228

Author(s):

Michaela Projahn ◽

Jana Sachsenroeder ◽

Guido Correia-Carreira ◽

Evelyne Becker ◽

Annett Martin ◽

...

Keyword(s):

Escherichia Coli ◽

Broiler Chickens ◽

Stocking Density ◽

Resistant Bacteria ◽

Control Group ◽

Cross Contamination ◽

High Prevalence ◽

On Farm ◽

The Impact ◽

Slow Growing

Cefotaxime (CTX)-resistant Enterobacteriaceae are still an ongoing challenge in human and veterinary health. High prevalence of these resistant bacteria is detected in broiler chickens and the prevention of their dissemination along the production pyramid is of major concern. The impact of certain on-farm interventions on the external bacterial contamination of broiler chickens, as well as their influence on single processing steps and (cross-) contamination, have not yet been evaluated. Therefore, we investigated breast skin swab samples of broiler chickens before and during slaughter at an experimental slaughter facility. Broiler chickens were previously challenged with CTX-resistant Escherichia coli strains in a seeder-bird model and subjected to none (control group (CG)) or four different on-farm interventions: drinking water supplementation based on organic acids (DW), slow growing breed Rowan × Ranger (RR), reduced stocking density (25 kg/sqm) and competitive exclusion with Enterobacteriales strain IHIT36098(CE). Chickens of RR, 25 kg/sqm, and CE showed significant reductions of the external contamination compared to CG. The evaluation of a visual scoring system indicated that wet and dirty broiler chickens are more likely a vehicle for the dissemination of CTX-resistant and total Enterobacteriaceae into the slaughterhouses and contribute to higher rates of (cross-) contamination during processing.

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Environmental and economic sustainability in public contexts: the impact of hand-drying options on waste management, carbon emissions and operating costs

Environment Development and Sustainability ◽

10.1007/s10668-020-01109-x ◽

2021 ◽

Author(s):

Graziano Coller ◽

Marco Schiavon ◽

Marco Ragazzi

Keyword(s):

Waste Treatment ◽

Treatment Options ◽

Ghg Emissions ◽

Public Institution ◽

Reference Scenario ◽

Drying Method ◽

Alternative Scenario ◽

The Impact ◽

Paper Towels ◽

Hand Drying

AbstractDue to the high density of users hosted everyday, public buildings are important producers of waste and emissions of greenhouse gases (GHGs). Public restrooms play an underrated role in waste generation and GHG emissions, especially if paper towels are used as the hand-drying method. The choice of the hand-drying method (i.e., paper towels vs. electrical hand dryers) also affects the economic balance of a public institution, involving costs for the purchase of hand-drying materials/apparatuses, energy and waste disposal. The present paper aims at evaluating the economic and environmental impact of the introduction of electrical hand dryers (alternative scenario) in place of paper towels (reference scenario) in a public building. The paper presents a solid methodology, based on a numerical experiment approach, to identify a decision criterion for establishing the economical convenience of adopting the alternative scenario in public restrooms. Key factors affecting the choice between the proposed alternatives are presented and discussed in a dedicated sensitivity analysis. From the environmental point of view, this study evaluates the impact of each scenario in terms of GHG emissions, related to multiple waste treatment options and different electric grid mixes. Based on the experimental assumptions, the method allowed concluding that the alternative scenario becomes economically convenient when the number of daily usages (N) is > 57 ± 4. The environmental convenience of the alternative scenario is visible even at N < 10. The method here described can be successfully used to support strategic decisions for cost optimization and environmental mitigation in institutional buildings.

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Multidrug-resistant bacteria isolated from surgical site of dogs, surgeon's hands and operating room in a veterinary teaching hospital in Brazil

10.21203/rs.3.rs-216652/v1 ◽

2021 ◽

Author(s):

Mareliza Possa de Menezes ◽

Mariana Borzi ◽

Mayara Ruaro ◽

Marita Cardozo ◽

Fernando Ávila ◽

...

Keyword(s):

Multidrug Resistant ◽

High Rate ◽

Resistant Bacteria ◽

Coagulase Negative Staphylococci ◽

Gram Negative ◽

Source Of Infection ◽

The One ◽

Clean Contaminated ◽

In The Beginning ◽

Coagulase Positive Staphylococci

Abstract The aim of this study was to evaluate the prevalence and antimicrobial resistance profile of Gram-positive cocci and Gram-negative bacilli isolated from the surgical environment. All samples were collected during the intraoperative period of clean/clean-contaminated (G1) and contaminated (G2) surgery. A total of 150 samples were collected from the surgical wound in the beginning (n = 30) and end (n = 30) of the procedure, surgeon’s hands before (n = 30) and after (n = 30) antisepsis and the surgical environment (n = 30). Forty-three isolates with morphological and biochemical characteristics of Staphylococcus spp. and 13 of Gram-negative bacilli were obtained. Coagulase-negative staphylococci (85.71% [18/21]), coagulase-positive staphylococci (9.52% [2/21]) and Pseudomonas spp. (47.52% [1/21]) in G1, and coagulase-negative staphylococci (40% [14/35]), coagulase-positive staphylococci (20% [7/35]), Proteus spp. (17.14% [6/35]), E. coli (8.57% [3/35]), Pseudomonas spp. (2.86% [1/35]) and Salmonella spp. (2.86 [1/35]) in G2 were more frequently isolated, and a high incidence of multidrug resistance was observed in coagulase-negative staphylococci (87.5% [28/32]), coagulase-positive staphylococci (100% [11/11]) and Gram-negative bacilli (76.92% [10/13]). Methicillin-resistant Staphylococcus spp. accounted for 83.72% (36/43) of the Staphylococcus strains. Gram-negative bacilli cefotaxime-resistance constituted 81.82% (9/11) and imipenem resistance constituted 53.85% (7/13). The high rate of resistance of commensal bacteria found in our study is worrying. Coagulase-negative staphylococci are community pathogens related to nosocomial infections in human and veterinary hospitals, their presence in healthy patients and in veterinary professionals represent an important source of infection in the one health context. Continuous surveillance and application of antimicrobial stewardship programs are essential in the fight against this threat.

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REDUCING THE NUMBER OF BACTERIAL COLONIES USING ECOCID®S (POTASSIUM PEROXYSULPHATE BASED DISINFECTANT) AT SMALL ANIMAL CLINIC

Slovenian Veterinary Research ◽

10.26873/svr-589-2020 ◽

2020 ◽

Vol 57 (2) ◽

Author(s):

Nataša Tozon ◽

Majda Biasizzo ◽

Leon Ščuka ◽

Tamara Potočnik ◽

Marjeta Redek ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Study ◽

Microbial Contamination ◽

Small Animal ◽

Before And After ◽

Microbiological Testing ◽

Sources Of Infection ◽

Time Required ◽

Paper Towels ◽

Reduced Time

A clinical study has been conducted to test the efficacy of Ecocid® S, a biocidal agent. The active substance is potassium peroxysulphate and is used in clinical practice after the mechanical cleaning of various surfaces that act as potential sources of infection transmission. We determined 29 swabbing points, from which 87 samples were collected with cotton swabs. Swabs were submitted for microbiological testing to evaluate microbial contamination before cleaning, and before and after disinfection with Ecocid® S. We submitted 63 swabs from 21 swabbing points for further statistical analysis. Five swabs were excluded because the presence of bacteria in the swabs before disinfection had not been determined. The clinical study on the efficacy of Ecocid® S disinfectant showed that it is effective with an average reduction in contamination of 95.75%. The disinfectant was also active with a significantly reduced time of action: it was removed with dry paper towels from all sampling points, except the floor scales, only 5 to 10 minutes after application. The time required for the proper preparation of examination tables and other equipment in clinical practice is of vital importance for a smooth workflow.Key words: animals; disinfection; potassium peroxysulphate; Ecocid® S ZMANJŠANJE ŠTEVILA BAKTERIJ PO UPORABI RAZKUŽILA ECOCID®S (RAZKUŽILO NA OSNOVI KALIJEVEGA PEROKSISULFATA) V PROSTORIH KLINIKE ZA MALE ŽIVALIPovzetek: S klinično študijo smo želeli ugotoviti učinkovitosti biocidnega razkužila ECOCID®S. Aktivna snov v razkužilu je kalijev peroksisulfat, ki se na klinikah uporablja za razkuževanje različnih površin, ki predstavljajo ključna mesta za prenos okužb, po njihovem mehaničnem čiščenju. Določili smo 29 vzorčnih mest, na katerih smo z uporabo bombažnih brisov odvzeli 87 vzorcev. Z mikrobiološkim testiranjem smo ugotavljali stopnjo kontaminacije pred čiščenjem, ter pred in po razkuževanju z ECOCID®S. Za statistično obdelavo smo uporabili 63 rezultatov z 21 vzorčnih mest. Pet rezultatov je bilo izločenih iz obdelave, ker je bila že pred razkuževanjem stopnja kontaminacije pod mejo detekcije uporabljene metode. S klinično študijo učinkovitosti razkužila Ecocid®S smo ugotovili povprečno 95,75 % zmanjšanje števila kontaminantov po uporabi razkužila. Razkužilo je bilo učinkovito tudi ob skrajšanem času delovanja le 5 do 10 minut po nanosu. Zaradi zagotavljanja tekočega dela na kliniki je izredno pomemben čas, ki je potreben za ustrezno pripravo površin in druge opreme za pregled živali, zato je razkužilo Ecocid® S primerno za uporabo na veterinarskih klinikah, saj hitro in učinkovito zmanjša bakterijsko kontaminacijo.Ključne besede: živali; dezinfekcija; kalijev peroksisulfat; Ecocid® S

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Multidrug-Resistant Bacteria Associated with Cell Phones of Healthcare Professionals in Selected Hospitals in Saudi Arabia

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2018/6598918 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Saeed Banawas ◽

Ahmed Abdel-Hadi ◽

Mohammed Alaidarous ◽

Bader Alshehri ◽

Abdul Aziz Bin Dukhyil ◽

...

Keyword(s):

Saudi Arabia ◽

Cell Phone ◽

Healthcare Workers ◽

Cell Phones ◽

Acute Otitis Media ◽

Pseudomonas Stutzeri ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Bacterial Isolates ◽

Coagulase Negative Staphylococci

Cell phones may be an ideal habitat for colonization by bacterial pathogens, especially in hot climates, and may be a reservoir or vehicle in transmitting nosocomial infections. We investigated bacterial contamination on cell phones of healthcare workers in three hospitals in Saudi Arabia and determined antibacterial resistance of selected bacteria. A questionnaire was submitted to 285 healthcare workers in three hospitals, and information was collected on cell phone usage at the work area and in the toilet, cell phone cleaning and sharing, and awareness of cell phones being a source of infection. Screening on the Vitek 2 Compact system (bioMérieux Inc., USA) was done to characterize bacterial isolates. Of the 60 samples collected from three hospitals, 38 (63.3%) were positive with 38 bacterial isolates (4 Gram-negative and 34 Gram-positive bacteria). We found 38.3% of cell phones were contaminated with coagulase-negative staphylococci, particularly Staphylococcus epidermidis (10 isolates). Other bacterial agents identified were S. aureus, S. hominis, Alloiococcus otitis, Vibrio fluvialis, and Pseudomonas stutzeri. Antimicrobial susceptibility testing showed that most coagulase-negative staphylococci were resistant to benzylpenicillin, erythromycin, and rifampicin. Eight isolates were resistant to oxacillin, specifically S. epidermidis (3), S. hominis (2), and S. warneri (2). A. otitis, a cause of acute otitis media showed multidrug resistance. One isolate, a confirmed hetero-vancomycin intermediate-resistant S. aureus, was resistant to antibiotics, commonly used to treat skin infection. There was a significant correlation between the level of contamination and usage of cell phone at toilet and sharing. Our findings emphasize the importance of hygiene practices in cell phone usage among healthcare workers in preventing the transmission of multidrug-resistant microbes.

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The neglected element of hand hygiene - significance of hand drying, efficiency of different methods and clinical implication: A review

Journal of Infection Prevention ◽

10.1177/1757177418815549 ◽

2018 ◽

Vol 20 (2) ◽

pp. 66-74 ◽

Cited By ~ 4

Author(s):

John Gammon ◽

Julian Hunt

Keyword(s):

Hand Hygiene ◽

Environmental Contamination ◽

Environmental Sustainability ◽

Critical Factor ◽

Drying Methods ◽

Clinical Environment ◽

Occupational Contact Dermatitis ◽

Drying Efficiency ◽

The Impact ◽

Hand Drying

Hand hygiene is a fundamental strategy for controlling the spread of infection. Careful hand drying is integral to the process of hand hygiene, which aims to optimise the removal of potentially pathogenic microorganisms. Ineffective hand drying results in wet hands that are an infection risk increasing the potential for cross-infection, occupational contact dermatitis for healthcare practitioners, harm to patients and environmental contamination. Evidence indicates that there has been limited research regarding the significance of hand drying and the efficacy and clinical impact of different drying methods. The purpose of this review paper was to scope and evaluate the existing literature pertaining to hand drying; to examine the clinical consequences associated with wet hands for patients, healthcare practitioners and the clinical environment; to assess the efficacy of different drying methods; to consider the impact on patient safety; and to progress the research, debate and practice relating to hand drying. The methodological framework applied in this review was that of Arksey and O’Malley (2007). Twenty-one papers identified from 112 abstracts screened were included in the review. Analysis identified three primary themes emerging from the literature: (1) efficacy of hand drying methods; (2) drying method and microbial translocation, dispersion and environmental contamination; and (3) drying methods and environmental sustainability. This review highlights the equal importance of hand drying in the process of hand hygiene and suggests that the efficacy of hand drying is a critical factor in the prevention of the transfer of microorganisms to the environment, and from person to person following hand washing. In conclusion, this paper argues that greater attention needs to be given to hand drying in terms of practice, policy and research and its importance in clinical settings given greater focus.

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Control Points To Reduce Movement of Central Nervous System Tissue during Beef Slaughter

Journal of Food Protection ◽

10.4315/0362-028x.jfp-16-302 ◽

2017 ◽

Vol 80 (2) ◽

pp. 355-360

Author(s):

J. L. Aalhus ◽

R. D. Thacker ◽

I. L. Larsen ◽

J. C. Roberts ◽

M. A. Price ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Cold Water ◽

Effective Means ◽

Hot Water ◽

Spongiform Encephalopathy ◽

Cross Contamination ◽

Central Nervous System Tissue ◽

Before And After ◽

Disease Variant

ABSTRACT Consumption of central nervous system tissue (CNST) from cattle with bovine spongiform encephalopathy (BSE) is thought to cause the human neurological disease, variant Creutzfeldt-Jacob disease. To identify points of cross-contamination of beef carcasses with CNST, 55 young beef cattle were slaughtered and processed through a federally inspected multispecies abattoir. The objectives of this study were to evaluate CNST spread following the placement of a plug in the penetration site of the skull after captive bolt stunning, to evaluate cross-contamination of carcasses before and after splitting, to compare the effects of hot water pasteurization (84°C for 10 s) versus cold water wash (10°C for 30 s) for reducing CNST on the carcass, and to examine other possible sources of cross-contamination in the abattoir. Results indicated that the use of a plastic plug reduced CNST contamination near the bolt penetration site. This study also confirmed that carcass splitting resulted in an increase in CNST contamination at various areas of the carcass. Hot water pasteurization appeared to be an effective means of removing CNST contamination from carcasses in most of the areas sampled.

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