Skip to Content

Hand Hygiene and Pathogens in Public Restrooms

Fri 5th Jan, 2024 Infection Prevention

Many people use handwashing and hand-drying facilities in public washrooms under the impression that these amenities are hygienic. However, such facilities may be potential sites for the transmission of pathogenic bacteria. A study by Suen, et al. (2019) published in Infection Control Today aimed to examine the hygiene facilities provided including handwashing and hand-drying facilities in public washrooms. Total bacterial counts and species identification were determined for hand-drying facilities. Antimicrobial susceptibilities were performed.

The bacterial contamination levels of 55 public washrooms ranging in category from disadvantaged communities to high-end establishments, were examined. The hygienic environment and facilities of the washrooms were analysed using an electronic checklist to facilitate immediate data entry. Pre-moistened sterile swabs were used to collect samples from areas around the outlet of paper towel dispensers, air outlet of air dryers, exit door handles and paper towels in the washrooms. Total bacterial counts were performed and isolates identified using matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. Antimicrobial susceptibility was determined by disk diffusion. The results were disturbing.

The high- and middle-income categories washrooms generally had cleaner facilities and environment followed by those in low categories. Fifty-two bacterial species were identified from the 55 investigated washrooms. Over 97% of the pathogenic Staphylococcus spp. tested were resistant to at least one first-line antimicrobial therapeutic agent, including penicillin, cefoxitin, erythromycin, co-trimoxazole, clindamycin and gentamicin, and 22.6% demonstrated co-resistance to at least three antimicrobial agents, with co-resistance to penicillin, erythromycin and clindamycin being the most common.

The researchers suggested that hand-drying facilities in public washrooms can act as reservoirs of drug-resistant bacteria. Please be sure to work with your housekeeping team to be certain the solutions they are using and the techniques deployed are consistent with the latest infection control protocols. Ensure that all solutions used are designed for use in healthcare facilities to foster the best results.