Role of Hand Washing Antiseptics in Open Containers as Source of Pathogens in Nosocomial Infections

Contaminated hand washing antiseptics act as source of multi-drug and disinfectant resistant isolates in nosocomial infections through hands of Health care workers(HCW). Limited data available necessitated the present study. To determine rate of contaminated hand-washing antiseptic solutions in open containers(cHWAOC) by In-use test. To analyze role of cHWAOC in nosocomial infections as source of pathogens.Cross sectional prospective observational study of two months was conducted. 46 of 65 HWAOC from wards, OPDs,Casualty and ICUs were studied for microbial contamination by In-use test. Isolation, identification, antimicrobial susceptibility testing and antibiogram typing of isolates was done by standard laboratory procedures. Questionnaire surveywas used to asses hand washing practices in HWAOC. Correlation of isolates from cHWAOC with nosocomial infections was done by antibiogram typing and temporospatial association. Rate of c HWAOC was 2 8.26% ( 13/46). Distribution of cHWAOC was 21.8%, 50%, 66.67% and 15.38% respectively in wards, ICUs, Casualty and OPDs(P >0.05 NS). With an overall association in 11 nosocomial infections. Pseudomonas aeruginosa(5 antibiogram types) was predominant isolate(29.41%), followed by A. baumannii[3 types ] (17.64%) with association in 5 and 4 nosocomial infections respectively. Questionnaire survey revealed use of savlon in 80.43% of HWAOC with variable concentrations(2.5% to 17%v/v). Changing antiseptics in HWAOC was highly variable. Majority of the containers were washed by soap and water(73.9%). Higher rate of cHWAOC with Pseudomonas aeruginosa and Acinetobacter baumannii as most common isolates was observed. Possible role of cHWAOC as source of nosocomial pathogens could not be ruled out by antibiogram typing of isolates. Use of HWAOC in health care settings should be banned.