Clostridium difficile contamination of health care workers' hands and its potential contribution to the spread of infection: Review of the literature

Publication date: 1 January 2017
Source:American Journal of Infection Control, Volume 45, Issue 1
Author(s): Ingrid Jullian-Desayes, Caroline Landelle, Marie-Reine Mallaret, Christian Brun-Buisson, Frédéric Barbut
BackgroundClostridium difficile infection (CDI) can be transmitted from patient to patient by the hands of health care workers (HCWs); however, the relative importance of this route in the spread of C difficile in the hospital is currently unknown. Our aim was to review studies examining HCWs' hand carriage and its potential role in CDI transmission.MethodsFirst, English-speaking references addressing HCWs' hand sampling obtained from the PubMed database were reviewed. Second, C difficile outbreaks definitely or probably implicating HCWs were retrieved from the Outbreak Database Web site (http://ift.tt/2hVJ76N). Finally, cases of C difficile occurring in HCWs after contact with an infected patient were retrieved from PubMed.ResultsA total of 11 studies dealing with HCWs' hand carriage were selected and reviewed. Between 0% and 59% of HCWs' hands were found contaminated with C difficile after caring for a patient with CDI. There were several differences between studies regarding site of hands sampling, timing after contact, and bacteriologic methods. Only 2 C difficile outbreaks implicating HCWs and 6 series of cases of transmission from patients to HCWs have been reported.ConclusionsThis review shows that HCWs' hands could play an important role in the transmission of C difficile. Hand hygiene and reduction of environmental contamination are essential to control C difficile transmission.



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