Impact of Hand-Drying Method on Bacteria Levels in Hospital Washrooms

Now in its 11th year, the IPS Conference gathers leading experts from across Europe and beyond. Wilcox’s 30-minute presentation is based on the multicentre study he led in France, Italy and UK, exploring the prevalence of environmental contamination – including by antibiotic resistant bacteria – in hospital toilets used by visitors, staff and patients according to two hand drying methods: paper towels and jet air dryers.

Laboratory and in situ studies have demonstrated that some hand drying methods are associated with a greater risk of dissemination of residual microbes from hands after (especially suboptimal) handwashing. In this latest study, supported by a grant from ETS, two toilets per hospital were observed – each had paper towel dispensers and jet air hand dryers, but only one of these was available to use at any given time – the hand drying method was changed every four weeks. The toilets were frequented by patients, visitors and staff. Bacterial contamination levels were measured over 12 weeks. Target bacteria included methicillin susceptible (MSSA) and resistant Staphylococcus aureus (MRSA), enterococci and enterobacteria, including ESBL (extended-spectrum β-lactamase) bacteria.

Higher levels of contamination were measured in toilets using a jet air dryer compared with those using paper towels. There were multiple examples of significant differences in the extent of surface bacterial contamination, including by faecal associated (enterococci and enterobacteria) and antibiotic resistant bacteria (MRSA and ESBL-producing bacteria). The study demonstrated that hand drying method can affect the risk of airborne dissemination of bacteria in real-world settings. They should be of particular interest to infection prevention and control doctors and nurses, procurement managers and all responsible for minimising the spread of cross–infection in hospitals.

Commenting on the study he led, Wilcox said, “Hand hygiene is one of the most important components of infection prevention and these findings have serious implications for minimising the spread of bacteria including MRSA, enterobacteria and enterococci in hospital toilets.”