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Article: Extent and predictors of microbial hand contamination in a tertiary care ophthalmic outpatient practice

TitleExtent and predictors of microbial hand contamination in a tertiary care ophthalmic outpatient practice
Authors
Issue Date2005
PublisherAssociation for Research in Vision and Ophthalmology. The Journal's web site is located at http://www.iovs.org
Citation
Investigative Ophthalmology And Visual Science, 2005, v. 46 n. 10, p. 3578-3583 How to Cite?
AbstractPURPOSE. To measure the extent of microbial hand contamination among ophthalmologists during routine clinic practice and examine its association with hand cleansing practices and beliefs, glove use, and patient load. METHODS. This was a single-masked analysis of resident and transient flora of ophthalmologists before and after patient examination and after handwashing by agar imprints of the dominant hand. Standardized questionnaires were used to collect information concerning subjects' hand cleansing practices and patient load. RESULTS. Of the 108 cultures, 107 (99.1%) were culture positive, yielding 15 separate organisms. Gram-negative bacilli were the most common transient flora, followed by Gram-positive cocci and fungi. Thirty-five (97.2%) ophthalmologists were culture positive for at least one resident and 8 (22.2%) ophthalmologists were culture positive for at least one transient organism, before patient contact. Regression models showed alcohol-based hand rub use, transient and resident floral load before patient contact, and patient load collectively accounted for 58.7% of the variance in resident floral load after patient contact. Use of alcohol-based hand rubs was associated with a mean resident floral reduction of 324.4 CFUs (95% confidence interval [CI] = 185.4 to 463.5; P < 0.01) and 31.6 CFUs (95% CI = 1.2 to 62.0; P < 0.05) after patient contact and handwashing, respectively. Handwashing with chlorhexidine was a significant predictor for transient floral load after handwashing (unstandardized β = -17.2; 95% CI = -10.2 to -24.2; P < 0.01). CONCLUSIONS. The extent of contamination with pathogenic organisms after contact with eye outpatients, who have traditionally been perceived as relatively "clean," was of concern. Previously identified risk factors for hand contamination in inpatient settings, such as patient load, only explained a small proportion of variance in microbial load in the ophthalmic outpatient setting. Copyright © Association for Research in Vision and Ophthalmology.
Persistent Identifierhttp://hdl.handle.net/10722/86690
ISSN
2023 Impact Factor: 5.0
2023 SCImago Journal Rankings: 1.422
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, RFen_HK
dc.contributor.authorHui, Men_HK
dc.contributor.authorLeung, DYLen_HK
dc.contributor.authorChow, VCYen_HK
dc.contributor.authorLam, BNMen_HK
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorLam, DSCen_HK
dc.date.accessioned2010-09-06T09:20:08Z-
dc.date.available2010-09-06T09:20:08Z-
dc.date.issued2005en_HK
dc.identifier.citationInvestigative Ophthalmology And Visual Science, 2005, v. 46 n. 10, p. 3578-3583en_HK
dc.identifier.issn0146-0404en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86690-
dc.description.abstractPURPOSE. To measure the extent of microbial hand contamination among ophthalmologists during routine clinic practice and examine its association with hand cleansing practices and beliefs, glove use, and patient load. METHODS. This was a single-masked analysis of resident and transient flora of ophthalmologists before and after patient examination and after handwashing by agar imprints of the dominant hand. Standardized questionnaires were used to collect information concerning subjects' hand cleansing practices and patient load. RESULTS. Of the 108 cultures, 107 (99.1%) were culture positive, yielding 15 separate organisms. Gram-negative bacilli were the most common transient flora, followed by Gram-positive cocci and fungi. Thirty-five (97.2%) ophthalmologists were culture positive for at least one resident and 8 (22.2%) ophthalmologists were culture positive for at least one transient organism, before patient contact. Regression models showed alcohol-based hand rub use, transient and resident floral load before patient contact, and patient load collectively accounted for 58.7% of the variance in resident floral load after patient contact. Use of alcohol-based hand rubs was associated with a mean resident floral reduction of 324.4 CFUs (95% confidence interval [CI] = 185.4 to 463.5; P < 0.01) and 31.6 CFUs (95% CI = 1.2 to 62.0; P < 0.05) after patient contact and handwashing, respectively. Handwashing with chlorhexidine was a significant predictor for transient floral load after handwashing (unstandardized β = -17.2; 95% CI = -10.2 to -24.2; P < 0.01). CONCLUSIONS. The extent of contamination with pathogenic organisms after contact with eye outpatients, who have traditionally been perceived as relatively "clean," was of concern. Previously identified risk factors for hand contamination in inpatient settings, such as patient load, only explained a small proportion of variance in microbial load in the ophthalmic outpatient setting. Copyright © Association for Research in Vision and Ophthalmology.en_HK
dc.languageengen_HK
dc.publisherAssociation for Research in Vision and Ophthalmology. The Journal's web site is located at http://www.iovs.orgen_HK
dc.relation.ispartofInvestigative Ophthalmology and Visual Scienceen_HK
dc.subject.meshBacteria - isolation & purificationen_HK
dc.subject.meshColony Count, Microbialen_HK
dc.subject.meshCross Infection - prevention & controlen_HK
dc.subject.meshCross-Sectional Studiesen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGloves, Protective - utilizationen_HK
dc.subject.meshHand - microbiologyen_HK
dc.subject.meshHandwashing - standardsen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHospitals, Teachingen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInfection Control - methodsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshOphthalmology - manpoweren_HK
dc.subject.meshOutpatientsen_HK
dc.subject.meshPersonnel, Hospitalen_HK
dc.subject.meshQuestionnairesen_HK
dc.titleExtent and predictors of microbial hand contamination in a tertiary care ophthalmic outpatient practiceen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0146-0404&volume=46&spage=3578&epage=3583&date=2005&atitle=Extent+and+predictors+of+microbial+hand+contamination+in+a+tertiary+care+ophthalmic+outpatient+practiceen_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1167/iovs.05-0216en_HK
dc.identifier.pmid16186336-
dc.identifier.scopuseid_2-s2.0-32944470029en_HK
dc.identifier.hkuros116104en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-32944470029&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume46en_HK
dc.identifier.issue10en_HK
dc.identifier.spage3578en_HK
dc.identifier.epage3583en_HK
dc.identifier.isiWOS:000232112900017-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLam, RF=7101916693en_HK
dc.identifier.scopusauthoridHui, M=24075844900en_HK
dc.identifier.scopusauthoridLeung, DYL=13309931100en_HK
dc.identifier.scopusauthoridChow, VCY=7006616211en_HK
dc.identifier.scopusauthoridLam, BNM=25644608300en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridLam, DSC=35500200200en_HK
dc.identifier.issnl0146-0404-

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