Cross-sectional survey of hand-hygiene compliance and attitudes of health care workers and visitors in the intensive care units at King Chulalongkorn Memorial Hospital.

BACKGROUND: Hand hygiene is the most important and effective measure to prevent cross-infection in hospitals. Hand-hygiene campaign must be implemented as a part of infection control program at King Chulalongkorn Memorial Hospital (KCMH). The behavior attitudes, and beliefs of health care workers (HCWs) and visitors regarding hand-hygiene practices have never been studied in KCMH. OBJECTIVES: To determine the baseline compliance and assess the attitudes and beliefs regarding hand hygiene of HCWs and visitors in intensive care units (ICUs) at KCMH. MATERIAL AND METHOD: We observed hand-hygiene compliance of HCWs and visitors in ICUs before patient contact for eight hours. A self-administered questionnaire was employed to measure attitudes and beliefs about hand hygiene for two-week period. RESULTS: Overall hand-hygiene compliance obtained from this observational study was less than 50% and differed markedly among various professional categories of HCWs and visitors. In questionnaire-based study, patient needs perceived as a priority (51.2%) was the most common reason for non-compliance, followed by forgetfulness (35.7%), and skin irritation by hand-hygiene agents (15.5%). Subjects believed to improve their compliance by multiple strategies including available low irritating hand-hygiene agents (53.4%), information of current nosocomial infection rate (49.1%), and easily accessed hand-hygiene supplies (46.3%). Almost all subjects (99.7%) claimed to know correct hand-hygiene techniques. Handwashing with medicated soap was perceived to be the best mean of hand decontamination (37.8%). CONCLUSION: Hand-hygiene compliance of HCWs and visitors is unacceptably low. Their knowledge, behavior attitudes, and beliefs toward hand hygiene need to be improved by the multimodal and multidisciplinary approach.

Detection of pathogenic leptospiral DNA in urine by polymerase chain reaction.

Diagnosis of leptospirosis is currently based on serological tests detecting antibodies against the spirochete. The standard method is the microscopic agglutination test (MAT), which is serovar-specific, requires a period of antibody development, and increases the risk of exposure to viable organisms. Therefore, the present study aimed to develop a rapid, sensitive, specific, and safe method based on the PCR technique to detect pathogenic Leptospira in urine samples. Nested PCR using two sets of primers, external and internal primers, were shown to specifically amplify 16S rRNA target of patho-genic Leptospira. No amplification was observed when DNA from non-pathogenic Leptospira and other non-Leptospira bacteria were used as DNA templates. The method was able to detect as few as 10 leptospires in urine. Therefore, nested PCR approach may be a useful tool for prompt and definitive diagnosis of leptospirosis.