Volume 24, Issue 105, September - October, 2020

Evaluation of Hand Hygiene Compliance among Adult Intensive Care Units’ Visitors and Their Role as a Vector of Pathogens

Albaraa Altowijri^1♦, Khalid Alfifi², Maryam Alenzi³, Rabab Aljayani⁴, Ahmad Alanazi⁵, Abeer Asiri⁶, Mastorah Aljuhani³, Rama Abu Alez⁵, Tahani Alrashidi⁷

¹Assistant Professor/consultant pediatric and deformity orthopedic surgeon at Tabuk University, Tabuk, Saudi Arabia
²Lab specialist, King Fahad Specialists Hospital, Tabuk, Saudi Arabia
³Pediatric resident, king Salman Armed Forces Hospital, Tabuk, Saudi Arabia
⁴Medical student, University of Tabuk, Tabuk, Saudi Arabia
⁵Medical Intern, Tabuk University, Tabuk, Saudi Arabia
⁶General Practice, King Khalid hospital, Tabuk, Saudi Arabia
⁷MBBS, Tabuk University, Tabuk, Saudi Arabia

^♦Corresponding author
Albaraa Ahmad Altowijri Tabuk University, Tabuk city, Saudi Arabia Email: dr_altowijri79@hotmail.com / +996-548384225 / +966-507677555

ABSTRACT

Background: Patients admitted to intensive care units (ICUs) show an increased rate of health care-associated infections. Visitors play important role in the well-being of hospitalized patients, but unfortunately, they occasionally expose them to infection. Hand hygiene (HH) is considered the most important measure for preventing health care-associated infections. Objective: The aim of this study was to investigate HH compliance among ICU visitors, the role of visitors in transmission of infection, and the types of pathogens involved. Methods: The observers stationed outside and inside the ICU evaluated whether visitors performed hand hygiene at any of the wall-mounted alcohol-based hand sanitizer dispensers prior entering the ICU room. At entry of the ICU, a hand swab was taken from the welling visitor and another one was taken after existing in the ICU. The swabs were sent to the microbiology laboratories. Results: A total of 356 visitors were observed and participated in this study. Approximately one-fourth (26.4 %) of the study participants washed their hands with the existing alcoholic solution before entering the ICU. Among the 16 visitors who were positive for pathogenic organisms after exiting in the ICU, 13 did not perform hand hygiene before entering the ICU. Methicillin-resistant staphylococcus aureus was the only isolated Gram-positive organism either before or after the ICU entry. Antibiotic sensitivity testing revealed resistance to benzylpenicillin, erythromycin, and clindamycin. The patterns of antibiotic sensitivity/resistance of the isolated Gram-negative organisms revealed multidrug resistance. Conclusions: These results indicate poor hand hygiene compliance among ICU visitors. The visitors who did not perform hand hygiene before entering the ICU frequently showed pathogenic organisms and they posed a risk for ICU patients. In addition, the spectrum of the isolated bacterial species was diverse, and they showed a multidrug resistance pattern to different classes of antibiotics.

Keywords: intensive care unit, hand hygiene, compliance, visitors, hand swab, multidrug resistance

Medical Science, 2020, 24(105), 3796-3804

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