Ann Clin Microbiol.  2020 Dec;23(4):233-239. 10.5145/ACM.2020.23.4.2.

Cross-Correlation Analysis of the Incidence of Multidrug-Resistant Organisms with Hand Hygiene Compliance and Effectiveness of Alcohol-Gel Hand Hygiene Practice

• Baek EH
• Kim SE
• Kim DH
• Kim S

• KMID: 2509648
• DOI: http://doi.org/10.5145/ACM.2020.23.4.2

Abstract

Background
Multidrug- resistant organisms (MDRO) are a serious concern in healthcareassociated infections. Hand hygiene (HH) is essential to prevent the spread of MDRO in the healthcare institutes. The aim of this study was to investigate the relationship between the incidence of MDRO and hand hygiene compliance and the experimental effectiveness of alcohol-gel hand hygiene practice.
Methods
From March 2016 to September 2018, we analyzed the cross-correlation between the incidence of MDRO and the HH compliance each month at Gyeongsang National University Changwon Hospital. We employed an experiment to observe the effect of alcohol gel hand hygiene practice on the reduction of organisms on the hand surface using the handagar plates.
Results
Among the MDRO, only vancomycin-resistant enterococci (VRE) showed a moderate correlation with the HH rate (r = 0.55). The hand-agar plate experiment showed a significant bacterial reduction for inadequate HH (mean 3.47 CFU) and optimal HH (mean, 0.84 CFU) than before HH (mean, 11.56 CFU) (n = 32, P = 0.006).
Conclusion
The incidence of VRE showed a moderate correlation with HH among MDRO in the longitudinal analysis. HH practice was more effective in preventing the spread of VRE compared with other MDRO in our institute. Optimal alcohol-gel HH practice can effectively remove bacteria on the hand surface.

Figure

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  Fig. 1. Incidence of MRAB (multidrug-resistant Acinetobacter baumannii), VRE (vancomycin-resistant enterococci), CRE (carbapenem-resistant Enterobacteriacecae), MRSA (methicillin-resistant Staphylococcus aureus), MRPA (multidrug-resistant Pseudomonas aeruginosa) and hand hygiene (HH) compliance. Incidence is defined as new cases per 1,000 patient days.

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  Fig. 2. A photography of hand-agar plate culture (a) before hand hygiene (HH), (b) after inadequate HH, and (c) after adequate HH.

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  Fig. 3. Mean colony numbers of hand surface before hand hygiene (HH), after inadequate HH, and after adequate HH practices (n = 32).

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