Hygienic and bacteriological comparative studies in 50 hospitals. II. The role of staff in the distribution of pathogenic organisms in surgical wards

Abstract

Before hygienic measures are recommended to a hospital, it is absolutely necessary for the source of infection and the paths of infection, both possible and to be expected, to be clearly established. In order to be able to evaluate the paths of spread, one of the basic prerequisites would be to carry out examinations with a view to determining the number of persons who are carriers of pathogenic germs. To this effect, bacteriological samples of the right hand, the skin at the forehead/hairline, the coat in the area of the navel and the throat were taken from the nursing staff in surgical wards in 50 different hospitals. At the same time, details of hand disinfection and hand drying were collected by questioning and local inspection. In at least one of the 4 swabs from 72 persons (= 38%), and in 2 or more swabs from 26 persons (= 14%), Staph. aureus was detected. The hair was the most contaminated area, followed by the coat and hands, while the throat was the least contaminated zone. To prevent pathogenic germs being spread by hand, alcohol containing preparations were prevalently used (in 79% of the wards inspected). The hygienic hand disinfection was inadequate in 53% of the surgical wards. In 4 wards, the hands were washed with soap exclusively. 35% Of the surgical wards used common towels and disposable towels were used almost as frequently. In the remaining cases, common and disposable towels were employed simultaneously. Storage of the used and unused disposal towels was in the main unsatisfactory. In view of the conditions met with in the various hospitals, proper hand disinfection must be insisted on, i.e., the hands must first be disinfected with a tested preparation and then washed, as may be required. If time plays a major role, alcohol containing preparations should be used. Towels for common use must no longer be available in hospitals because they are important carriers of pathogenic germs.