Bacterial load and pathogenic species on healthcare personnel attire: implications of alcohol hand-rub use, profession, and time of duty

Background: Since hand hygiene might prevent the risk of bacterial transmission from healthcare personnel attire (HCPA), the present study investigates the effect of alcohol-based hand rub (ABHR) use on bacterial load and pathogenic species on HCPA. Methods: HCPA from doctors and nurses was investigated for bacterial contamination post duty. Samples from distinct areas of HCPA were obtained and analysed for bacterial load and species. A standardized questionnaire was performed regarding time of duty and profession, and ABHR from each ward was calculated according to a national standard. Findings: Bacterial load on HCPA (700 samples from 200 HCPA) was found to be up to fourfold higher when wearing for more than one shift. Moreover, doctors had a lower bacterial load on attire compared to nurses. In a multivariate linear regression model, negative correlations with bacterial load on HCPA were found for ABHR (t = -2.080, P = 0.0379) and being a doctor (t = -6.009, P < 0.0001), and a positive correlation for the time of duty (t = 10.572; P < 0.0001). Detection of Staphylococcus aureus as the most prominent pathogen found on HCPA was influenced by the time of duty (odds ratio: 3.27; 95% confidence interval: 1.93-5.72; P < 0.0001) but not by ABHR (1.22; 0.30-3.42). Conclusion: ABHR, profession, and time of duty significantly affect the bacterial load on HCPA. Since the time of duty has the strongest impact on bacterial load, a daily change of HCPA is recommended. (C) 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.