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Contamination of Healthcare Workers' Hands with Clostridium difficile Spores after Caring for Patients with C. difficile Infection

Published online by Cambridge University Press:  10 May 2016

C. Landelle ,
M. Verachten ,
P. Legrand ,
E. Girou ,
F. Barbut  and
C. Brun Buisson
C. Landelle*
Affiliation:
Infection Control Unit, Centre Hospitalier Universitaire (CHU) Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris–Est Créteil, France Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
M. Verachten
Affiliation:
Infection Control Unit, Centre Hospitalier Universitaire (CHU) Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris–Est Créteil, France
P. Legrand
Affiliation:
Department of Bacteriology-Virology, CHU Albert Chenevier–Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris–Est Créteil, France
E. Girou
Affiliation:
Infection Control Unit, Centre Hospitalier Universitaire (CHU) Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris–Est Créteil, France
F. Barbut
Affiliation:
National Reference Laboratory for Clostridium difficile,Hôpital Saint-Antoine, Assistance Publique–Hôpitaux de Paris, Paris, France
C. Brun Buisson
Affiliation:
Infection Control Unit, Centre Hospitalier Universitaire (CHU) Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris–Est Créteil, France Medical Intensive Care Unit, CHU Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris-Est Creteil, France
*
Infection Control Program, Geneva University Hospitals and Medical School, CH-1211 Geneva 14, Switzerland ([email protected])
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Abstract

Objective.

We determined the percentage of healthcare workers' (HCWs') hands contaminated with Clostridium difficile spores after caring for patients with C. difficile infection (CDI) and risk factors associated with contamination.

Design.

Prospective study.

Setting.

A French university hospital.

Methods.

We compared the hand contamination rate among HCWs caring for patients with CDI (exposed group; n = 66) with that among an unexposed group (n = 44). Spores of C. difficile were recovered from the hands of HCWs after rubbing their fingers and palms in alcohol shortly after patient care. Associations between hand contamination and HCW category, type (patient or environment), and risk level (high or low risk) of HCW contacts and their respective duration as well as use of gloves were analyzed by bivariate and multivariate analysis.

Results.

C. difficile spores were detected on 24% of HCWs' hands in the exposed group and on 0% in the unexposed group (P < .001). In the exposed group, logistic regression, which adjusted for high-risk contact (ie, exposure to fecal soiling), contact with the environment, and contact with or without use of gloves, revealed that high-risk contact (adjusted odds ratio [aOR] per 1 contact increment, 2.78; 95% confidence interval [CI], 1.42–5.45; P = .003) and at least 1 contact without use of gloves (aOR, 6.26; 95% CI, 1.27–30.78; P = .02) were independently associated with HCW hand contamination by C. difficile spores.

Conclusions.

Nearly one-quarter of HCWs have hands contaminated with C. difficile spores after routine care of patients with CDI. Hand contamination is positively associated with exposure to fecal soiling and lack of glove use.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 1 , January 2014 , pp. 10 - 15
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

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