Analysis of nosocomial outbreak caused by contamined liquid hand soaps: A single-center study

Abstract

Objective: P. aeruginosa and Klebsiella spp. are the most common gram negative pathogens seen in the etiology of hospital acquired infection outbreaks. Inadequate hygiene and contaminated liquid hand soaps have important roles in the spread of bacteria. In this study, we identified the source and causes of nosocomial infection outbreak in a tertiary hospital. Methods: CCulture samples were randomly obtained from soap dispensers filled with anionic liquid hand soap without antiseptic during the outbreak and from dispensers containing disposable liquid hand soap with antiseptic within the 5 years after the outbreak. The samples were cultivated in eosin methylene blue agar and blood agar mediums. In the identification of obtained samples, VITEK® 2 Compact automated system (bioMérieux, Marcy l'Etoile, France) was used. Results: Among culture samples obtained from 18 patients with coronary by-pass during nosocomial outbreak in our hospital in 2011, P. aeruginosa (n=17) and Klebsiella spp. (n=8) were isoled. . In culture samples of type A liquid hand soap group (anionic, antiseptic-free), P. aeruginosa (n=58) and Klebsiella spp. (n=15) were isolatedduring nosocomial infection outbreak and in the early periods after disinfection. No further nosocomial outbreak infections were detected during the next 5-year period after use of Soap type B (antiseptic foam soap) and Soap type C (disposable antiseptic liquid soap). A few number of pathogens including P. aeruginosa (n=1) and Klebsiella spp. (n=2) were isolated in culture samples obtained from Soap type B dispensers. No bacteria were isolated in samples obtained from Soap type C dispensers. Conclusion: The use of disposable liquid hand soap with antiseptic prohibits contamination and consequently, prevents nosocomial infection outbreaks. © 2019, Refik Saydam National Public Health Agency (RSNPHA).