Prevalence and Associated Factors of Hand Contamination with Gram-Negative Bacilli among Healthcare Workers in University Hospital Centers (CHUs) in Benin
Introduction: The dissemination of multidrug-resistant bacteria (MDRB) in hospital settings represents a major public health challenge, particularly in resource-limited countries. Healthcare workers’ hands constitute a critical yet insufficiently documented vector for the transmission of multidrug-resistant Gram-negative bacilli (MDR-GNB). This study aimed to determine the prevalence and associated factors of hand contamination with Gram-negative bacilli among healthcare workers in University Hospital Centers (CHUs) in Benin. Methods: This was a cross-sectional analytical study conducted in six CHUs in Benin. The study population consisted of healthcare workers directly involved in patient care, including physicians, nurses, and nursing assistants. Hand hygiene compliance was assessed through direct non-participant observation. In addition, microbiological analysis of hand samples collected from healthcare workers after hand hygiene was performed to detect Gram-negative bacilli (GNB), followed by antibiotic susceptibility testing for each isolated GNB. Results: Among the 339 healthcare workers surveyed, 267 (78.76%) demonstrated a low level of hand hygiene compliance. Microbiological analysis revealed that 186 healthcare workers (54.87%) had hands contaminated with GNB despite prior hand hygiene performance. The majority of the isolated GNB (171/186, 91.94%) were multidrug-resistant organisms. Hand hygiene compliance was significantly associated with sex (p = 0.013), hospital department (p = 0.031), and the type of hand hygiene commonly practiced (p < 0.001). The presence of GNB on healthcare workers’ hands was significantly associated with age group, professional category, and the type of hand hygiene practiced. Conclusion: These findings highlight the persistence of a high level of microbiological contamination of healthcare workers’ hands and emphasize the need for regular microbiological surveillance, particularly targeting high-risk professional categories such as nurses. Strengthening hand hygiene compliance appears essential to improving the quality of care and reducing the risk of healthcare-associated infections in hospitals in Benin.
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