Profile of bacterial pathogens contaminating hands of healthcare workers during daily routine care of patients at a tertiary hospital in northern Nigeria

Background: Healthcare associated infections (HAIs) have been recognized as a critical challenge affecting the quality of healthcare services provided. A significant proportion of these infections result from cross-contamination of microorganisms which are often acquired and spread by direct contact with patients or contaminated adjacent environmental surfaces through the hands of healthcare workers (HCWs). The objectives of this study are to profile bacterial pathogens commonly found on the hands of health care workers while routinely attending to patients in thehealthcare facility and to determine their antibiotic susceptibility pattern.Methodology: The fingers of the dominant hand of 300 HCWs at the Barau Dikko Teaching Hospital (BDTH), Kaduna, Nigeria, were imprinted on 5% Sheep blood, MacConkey, and Mannitol salt agar plates and incubated at 37°C for 24 hours. Bacteria isolates were identified by Gram staining and conventional biochemical tests. The susceptibility of isolated bacteria to selected antibiotics was determined by the modified Kirby–Bauer disk diffusion method and interpreted using the 2012 guidelines of the Clinical and Laboratory Standards Institute.Results: Bacteria were isolated from the hands of all 300 HCWs, with coagulase negative staphylococci (CONS) being the most frequent (67.0%, 201/300). Other bacteria identified were Staphylococcus aureus (23.7%, MRSA of 3%), Streptococcus pyogenes (2.7%), and Enterobacteriaceae (6%). The isolates were highly sensitive to ofloxacin 96.7% (290/300), augmentin 87.7% (263/300) and ceftriaxone 87.3% (262/300).Conclusion: This study demonstrates a high rate of contamination of hands of HCWs with potentially pathogenic bacteria, some of which were multidrug resistant. Concerted efforts should be made to implement programs dedicated to improve hand hygiene practices in the tertiary health care facility. Keywords: Hand hygiene, bacterial, pathogen, healthcare workers, healthcare associated infection   French title: Profil d'agents pathogenes bacteriens contaminant les mains des travailleurs de la sante lors des soins quotidiens de routine auxpatients d'un hopital tertiaire dans le nord du Nigeria   Contexte: Les infections associees aux soins de sante (IHA) ont ete reconnues comme un defi critique affectant la qualite des services de sante fournis. Une proportion importante de ces infections resulte de la contamination croisee de micro-organismes qui sont souvent acquis et propages par contact direct avec des patients ou des surfaces environnementales adjacentes contaminees par les mains des travailleurs de la sante (TS). Les objectifs de cette etude sont de dresser le profil des agents pathogenes bacteriens que l'on trouve couramment dans les mains des travailleurs de la sante tout en s'occupant regulierement des patients dans l'etablissement de sante et de determiner leur profil de sensibilite aux antibiotiques.Methodologie: Les doigts de la main dominante de 300 travailleurs de la sante au Barau Dikko Teaching Hospital (BDTH), Kaduna, Nigeria, ont ete imprimes sur des plaques de gelose au sang de mouton a 5%, MacConkey et Mannitol et incubes a 37°C pendant 24 heures. Les isolats de bacteries ont ete identifies par coloration de Gram et tests biochimiques conventionnels. La sensibilite des bacteries isolees aux antibiotiques selectionnes a  ete determinee par la methode de diffusion sur disque modifiee de Kirby-Bauer et interpretee en utilisant les lignes directrices de 2012 du Clinical and Laboratory Standards Institute.Resultats: les bacteries ont ete isolees des mains des 300 TS, les staphylocoques a coagulase negative (CONS) etant les plus frequents (67,0%, 201/300). Les autres bacteries identifiees etaient Staphylococcus aureus (23,7%, SARM de 3%), Streptococcus pyogenes (2,7%) et Enterobacteriaceae (6%). Les isolats etaient tres sensibles a l'ofloxacine 96,7% (290/300), a l'augmentationin 87,7% (263/300) et a la ceftriaxone 87,3% (262/300).Conclusion: Cette etude demontre un taux eleve de contamination des mains des travailleurs de la sante par des bacteries potentiellement pathogenes, dont certaines etaient multiresistantes. Des efforts concertes devraient etre faits pour mettre en œuvre des programmes visant a ameliorer les pratiques d'hygiene des mains dans les etablissements de soins de sante tertiaires. Mots-cles: hygiene des mains, bacterienne, pathogene, personnel de sante, infection associee aux soins de sante