Evaluation of Contamination of Hands of the Medical Students in a Medical Teaching Tertiary Care Hospital

In the hospital, patients are often exposed to multiple procedures, invasive devices etc., increasing their chances of contracting such potential pathogens. Most of the time, these potential pathogens exhibit multiple drug resistance. In view of the above factors, this study was undertaken to determine the rate of colonization of potential bacterial pathogens in the hands of final year MBBS undergraduate students. As per their clinical teaching curriculum, they visit the wards/ICU/OT, etc. on a daily basis.

Samples were collected from the hands of final year MBBS undergraduate students. The samples were collected by rubbing a saline wet swab stick onto the hands of the students and were inoculated onto nutrient agar plates for 18 - 24 hours at 37°C aerobically. Bacterial isolates were identified till species level by performing gram staining and biochemical reactions. Antibiotic susceptibility testing was done by Kirby-baur disc diffusion method as per CLSI guidelines 2016.

103 samples were collected from hands of final year undergraduate MBBS students by swab culture method. 38 showed growth and 65 showed no growth. Out of 38 isolates, 36 were Gram positive cocci and 2 were Gram positive bacilli. No Gram negative bacilli were isolated. Amongst 36 Gram positive cocci, 16 were coagulase positive Staphylococcus aureus and 20 were Coagulase negative Staphylococci (CoNS). 14 Staphylococcus aureus out of 16 were methicillin sensitive and 2 were methicillin resistant Staphylococcus aureus (MRSA). Out of 16 Staphylococcus aureus, 1 isolate showed Inducible Clindamycin Resistance (iMLS_B phenotype) and 6 isolates showed complete resistance to erythromycin and clindamycin (constitutive MLS_B phenotype). 1 Staphylococcus aureus which was Inducible Clindamycin Resistance (iMLS_B phenotype) was also methicillin resistant.

In conclusion, the study showed that these students were a strong factor that might contribute for transmission of hospital acquired infection as the bacterial isolates from their hands showed growth significant pathogens like Methicillin resistant Staphylococcus aureus, Staphylococcal strains with Inducible Clindamycin resistance, etc. So training of MBBS students should be imparted on a regular basis to curtail such spread.

Article by Keshvi Chauhan and Summaiya Mullan, from Government Medical College, Surat, India.

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