A Gayet-Ageron

D Pittet

M-N Chraiti

W Zingg

Antimicrobial Resistance and Infection Control

PubMed

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POSTER PRESENTATION Open Access
P216: Blood culture contamination as an indicator
of hand hygiene compliance
M-N Chraiti*, W Zingg, A Gayet-Ageron, D Pittet
From 2nd International Conference on Prevention and Infection Control (ICPIC 2013)
Geneva, Switzerland. 25-28 June 2013
Introduction
Hand hygiene (HH) monitoring by direct observation is
the gold standard for compliance measure but is highly
resource consuming. Indirect indicators could help to
overcome resource constraints that are identified as a
major obstacle to evaluate and feedback on HH practices.
HH compliance may impact on blood culture contamina-
tion (BCC) rate.
Objectives
The objective of the study was to explore the association
between HH compliance and BCC in a university affiliated
tertiary care hospital.
Methods
Ecological study combining prospective laboratory-based
surveillance of bacteraemia and repeated direct HH
observation over a study period of 15 consecutive quar-
ters between 2009 and 2012. Each positive blood culture
result was checked for aetiology using patient chart and
laboratory data. HH compliance observations were con-
ducted among all healthcare workers based on the World
Health Organization HH guidelines. Probable BCC and
nurse HH compliance were included in the analysis. Sub
analysis included data from the intensive care unit (ICU)
and the emergency room (ER).
Results
In total, 5388 positive blood culture episodes were identi-
fied, of which 677 (12.6%) were BCC, mainly due to skin
contaminants (91%). 154 (22.7%) and 217 (32.1%) were
attributed to ICU and ER, respectively. A significant trend
towards less BCC was found in the ICU (IRR [95%CI]:
0.96 [0.93-0.99]; P=0.047). A total of 13,393 HH opportu-
nities were observed in the hospital, 1882 in the ICU, and
379 in the ER. The total numbers of HH opportunities
before an aseptic task for hospital, ICU, and ER were
2558, 352, and 62, respectively. Average (range) HH com-
pliance for hospital, ICU, and ER was 0.69 (0.59-0.76; IRR:
1.01; P<0.001), 0.62 (0.53-0.70; P=0.86), and 0.50 (0.22-
0.74; P=98), respectively. A significant association between
HH and BCC was found in the ICU (IRR [95%CI]: 0.99
[0.98-0.99]; P=0.004). No other association was identified.
Conclusion
Although an association for overall HH compliance and
BCC was shown, this was not confirmed for the indication
“before an aseptic task”, neither in the ER due to a lack of
power. This finding needs to be verified with larger sam-
ples per time unit before concluding whether useful or
not.
Disclosure of interest
None declared.
Published: 20 June 2013
doi:10.1186/2047-2994-2-S1-P216
Cite this article as: Chraiti et al.: P216: Blood culture contamination as
an indicator of hand hygiene compliance. Antimicrobial Resistance and
Infection Control 2013 2(Suppl 1):P216.
Infection Control Programme, University of Geneva Hospitals, Geneva,
Switzerland
Chraiti et al. Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):P216
http://www.aricjournal.com/content/2/S1/P216
© 2013 Chraiti et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


P216: Blood culture contamination as an indicator of hand hygiene compliance

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P216: Blood culture contamination as an indicator of hand hygiene compliance

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