On May 5, World Hand Hygiene Day, announced by the World Health Organization with the slogan “Clean Care for Everyone is in Your Hands”, it is aimed to increase the compliance of healthcare professionals with hand hygiene in particular. Ankara University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology Faculty Member and Turkish Clinical Microbiology and Infectious Diseases Association (KLİMİK) Chairman of the Board of Directors. Dr. Alpay Azap touched on the relationship between hand hygiene and antibiotic resistance from a social perspective on 5 May World Hand Hygiene Day. Azap mentions that hand washing will protect us from microbes that are resistant to antibiotics and difficult to treat.
Mentioning that there are 150 types of bacteria on our hands, Prof. Dr. Alpay Azap mentioned that bacteria, viruses and fungi are transmitted to hands from every surface and object we touch, and that these can stay alive for hours until we wash our hands: “Hands serve as a very important tool in the transmission of diseases, since we put our hands to our mouth, nose and eyes approximately 25 times per hour. For this reason, only hand washing reduces the number of diarrhea cases by 50 percent and the number of respiratory tract infections by 25 percent.
Hand washing is the most basic way to prevent infections
Prof. Dr. Alpay Azap said that nosocomial infections develop in one in 10 patients treated in hospitals and that the most effective way to prevent these infections is to wash hands:
The importance of hand washing was first proven by the studies conducted by Semmelweiss in the mid-1800s. At the beginning of the 2000s, with the beginning of the attention of nosocomial infections, the efforts to prevent these infections gained momentum. The World Health Organization launched campaigns and prepared guides together with those working in the field of hand hygiene. In 2009, 5 May was declared as “World Hand Hygiene Day” in order to draw attention to the importance of the issue and to raise awareness. In this context, a theme is determined each year and campaign materials are prepared in accordance with this theme. Message of the year 2019 for healthcare professionals “Clean Care for All, It’s in Your Hands”
Washing hands helps fight antibiotic resistance
Diarrhea Since we constantly touch our eyes, nose and mouth without realizing it, microbes that can cause respiratory and respiratory tract infections can pass from person to person and cause diseases to spread when hands are not washed. Ensuring hand hygiene prevents diarrheal diseases, which are frequently observed with unnecessary antibiotic use, by about fifty percent, and respiratory infections by about 25 percent. Preventing the formation of these diseases also directly reduces the use of antibiotics, greatly reducing the risk of antibiotic resistance. Washing hands can also protect us from germs that are resistant to antibiotics and difficult to treat.
The compliance of healthcare professionals with hand hygiene reduces the risk of infection
Mentioning that bacteria that cause hospital infections are passed from patient to patient or from surfaces to patients through the hands of healthcare workers Prof. Dr. Alpay Azap stated that nosocomial infections developed in one in 10 of the hospitalized patients and in one in three of those hospitalized in the intensive care unit.
“There may be 40,000- 4,000,000 bacteria per square centimeter on the hands of healthcare professionals. This figure is 10-100 times higher than in people outside the hospital. Nosocomial infections can be reduced by half without any additional procedure or cost, just by complying with hand hygiene. Where compliance with hand hygiene is high, nosocomial infections are also low; It has been shown in many studies that there is a direct relationship between them.”
Hygienic hand cleaning should be applied before and after contact with patients
Stating that there are three types of hand washing, Prof. Dr. Alpay Azap listed these as social hand washing, hygienic hand washing and surgical hand washing.
“Social handwashing is a type of handwashing that should be practiced by everyone in daily life. After using the toilet, before and after meals, after petting animals and whenever our hands get dirty, hands should be washed with soap for at least 15 seconds and then dried.
Hygienic handwashing, on the other hand, is the type of handwashing required by healthcare professionals in hospitals, and attention is drawn to this type of handwashing every year on May 5, World Hand Hygiene Day.
Water and soap can be used for hygienic hand washing, as well as alcohol-based hand antiseptics.
How to wash hands?
For hygienic hand washing with soap and water, after wetting the hands, hands should be washed by rubbing them for at least 15 seconds with 3-5 ml of liquid soap. Then it should be rinsed and dried with a paper towel. Hand blood, secretion, etc. If there is no visible contamination, hygienic hand cleaning can be provided with alcohol-based hand antiseptics instead of hand washing.
Hygienic hand cleaning should be performed before and after touching patients, before and after any procedure. Finally, surgical handwashing is a type of handwashing applied with a special technique and special materials, which should be applied by healthcare professionals who will undergo surgery.
Hospital infection increases the length of stay and cost
Stating that patients and their relatives, healthcare professionals and managers should pay attention to hospital infections, Prof. Dr. Alpay Azap emphasized that when hospital infection develops, the patient may recover later and suffer more during this time.
“When hospital infection develops, the length of stay is prolonged and the cost increases. With proper hand hygiene in appropriate indications, nosocomial infections can be reduced by half without the need for additional effort and cost. It is important to provide training to health workers on this issue. In addition, it is the responsibility of the managers to have water, washbasins, soap, paper towels and hand antiseptics where necessary in hospitals. The importance of hand hygiene should be emphasized with various campaigns and encouraging activities in hospitals.
Widespread use of antibiotics causes antimicrobial resistance
Sharing important information about antimicrobial resistance, Prof. Dr. Alpay Azap stated that today we encounter bacteria that are resistant to more than one antibiotic.
When a bacterium becomes resistant to an antibiotic, it means that the antibiotic to which it is resistant cannot be used in the treatment of infections caused by that bacterium. Today, we encounter multiple—sometimes even dozens—antibiotic-resistant bacteria. The number of antibiotics that can be used for diseases caused by these bacteria is also decreasing, because bacteria can develop resistance to each of the antibiotics used rapidly.
Reasons for the increase in antibiotic resistance
One of the most important factors in the development of resistance is the widespread use of antibiotics. Turkey is one of the countries where antibiotics are consumed the most among all the countries in the world; As a result, it is among the countries with the highest antibiotic resistance in the world. An important way to prevent the spread of resistance is to follow infection control rules.
The most basic rule of infection control is hand hygiene. As hand hygiene compliance increases, nosocomial infections will decrease and therefore antibiotic use will decrease. This will prevent the emergence of resistant bacteria. Hand hygiene will also reduce infections with currently resistant bacteria.”