title: Effect of handrubbing using locally-manufactured alcohol-based handrubs in paediatric wards in Harare, Zimbabwe.
abstract: We assessed bacterial contamination of hands of adults present in paediatric wards in two tertiary-care hospitals in Harare, Zimbabwe and the microbiologic efficacy of locally-manufactured alcohol-based hand rub (ABHR). During unannounced visits, samples were collected using hand-print and hand-rinse methods. Samples were collected from 152 individuals (16 nurses, 10 doctors, 28 students, 86 parents/guardians, 12 others). Contamination of hands with Gram-negative bacteria was found in 91% of adults tested with a mean of 14.6 CFU (hand-rinse method; IQR 3-65), representing a high risk for transmission of pathogens potentially leading to nosocomial infections. A single application of ABHR under controlled conditions achieved an average of 82% (or 0.72 log) reduction in detectable counts. Amongst 49Enterobacteriaceaeisolates from hands, 53% were resistant to gentamicin and 63% were resistant to cefpodoxime. Use of ABHR represents an attractive intervention for reducing nosocomial infections in this setting.
authors.affiliation: National Microbiology Reference Laboratory, Harare Central Hospital, Harare, Zimbabwe.
authors.forename: Muchaneta
authors.initials: M
authors.lastname: Gudza-Mugabe
authors.affiliation: Department of Medical Microbiology, University of Zimbabwe-College of Health Sciences, Harare, Zimbabwe.
authors.forename: Marcelyn T
authors.initials: MT
authors.lastname: Magwenzi
authors.affiliation: Department of Paediatrics and Child Health, University of Zimbabwe-College of Health Sciences, Harare, Zimbabwe.
authors.forename: Hilda A
authors.initials: HA
authors.lastname: Mujuru
authors.affiliation: Department of Paediatrics and Child Health, University of Zimbabwe-College of Health Sciences, Harare, Zimbabwe ; Parirenyatwa Hospital, Harare, Zimbabwe.
authors.forename: Mutsa
authors.initials: M
authors.lastname: Bwakura-Dangarembizi
authors.affiliation: Department of Medical Microbiology, University of Zimbabwe-College of Health Sciences, Harare, Zimbabwe.
authors.forename: Valerie
authors.initials: V
authors.lastname: Robertson
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK ; Biomedical Research and Training Institute, Harare, Zimbabwe.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Aiken
keywords: Alcohol-based hand rub; Contamination; Gram negative bacteria; Hand hygiene; Nosocomial infection; Paediatric