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Original Article

Korean J healthc assoc Infect Control Prev 2011; 16(1): 18-28

Published online June 30, 2011 https://doi.org/10.14192/kjicp.2011.16.1.18

Copyright © Korean Society for Healthcare-associated infection Control and Prevention

Hand-Washing Practices Followed by Health Care Workers in a Tertiary Care Hospital Depending on Their Carriage Status for Nasally Transmitted Methicillin-Resistant Staphylococcus aureus

Seung Eun Lee1, Min Ja Kim2, Jang Wook Sohn2, and Byung Chul Chun3

Infection Control Unit, Korea University Anam Hospital1, Division of infectious Diseases2, Departments of Internal Medicine2 and Preventive Medicine3, Korea Universtiy, College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Hospital-wide surveillance showed an up to 9% increase in the incidence rate of the nasal transmission of methicillin-resistant Staphylococcus aureus (MRSA) among health care workers (HCWs) in a tertiary care hospital where MRSA is endemic. The purpose of this study was to investigate the knowledge of and attitude towards nasal transmission of MRSA and hand-washing practice among HCWs and determine the behavioral factors associated with the nasal transmission of MRSA. Methods: In a 750-bed tertiary care hospital, nasal swabs from HCWs were obtained, and questionnaires with 25 questions were distributed to HCWs who were divided into 2 different groups: MRSA carriers and non-carriers. The questionnaires focused on the HCWs' knowledge about the mode of MRSA transmission and precautions against MRSA infection and their self-reported compliance for hand hygiene. Results: The total number of respondents for the surveillance culture and survey were 253 (51 MRSA carriers and 202 non-carriers). There was significant difference between the 2 groups on the knowledge of precautionary measures used for the MRSA patients in the hospital (P=0.026). Compared to the MRSA carriers, the non-carriers washed their hands significantly more frequently after ventilator care (P=0.004) and used more alcohol sanitizers (P=0.023). However, no significant difference was observed in hand-washing practices of both the groups before the medical procedures, their knowledge about the mode of transmission of MRSA, and the duration of hand washing. Conclusion: Non-carriers replied more accurately to the questions on knowledge about the management and treatment of MRSA, and they considered interventions such as surveillance cultures and questionnaires to be an effective method in lowering the incidence of nosocomial infections. Compared to the MRSA carriers, the non-carriers showed higher hand-washing compliance.

Keywords: Methicillin-resistant Staphylococcus aureus (MRSA), Hand washing, Cross-sectional study, Drug resistance, Bacterial

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