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Official Journal of the Australasian College for Infection Prevention and Control
RESEARCH ARTICLE

Reduction of microbial transmission in childcare using an improved hand drying protocol

Daniel Patrick A , Thomas Miller B D and Douglas Ormrod C
+ Author Affiliations
- Author Affiliations

A New Zealand’s Māori Centre of Research Excellence, The University of Auckland, Private Bag 92019, AMC1142 Auckland, New Zealand.

B Department of Medicine, The University of Auckland, Private Bag 92019, AMC1142 Auckland, New Zealand.

C Neurological Foundation of New Zealand, PO Box 110022, 1148 Auckland, New Zealand.

D Corresponding author. Email: t.miller@auckland.ac.nz

Healthcare Infection 15(1) 15-19 https://doi.org/10.1071/HI09025
Submitted: 30 November 2009  Accepted: 5 February 2010   Published: 29 March 2010

Abstract

This study was designed to compare bacterial transfer by touch contact in a childcare setting after participants used their usual hand drying procedure or a prescribed dual hand drying system. Eleven children washed and dried their hands using bathroom facilities provided by the childcare centre. On completion of each hand hygiene episode, the child handled an item representing food, skin or a toy. The same procedure was carried out on a further occasion but in this case, after washing, the children dried their hands using a retractable cloth towel and a warm air towel before handling the item. A substantial reduction in the touch transfer of microorganisims was achieved when the dual hand drying system was used. Bacterial numbers translocating to skin, food or a toy were reduced by 82, 84 and 96%, respectively, when the dual hand drying system replaced the child’s usual routine. Children between the ages of 3 and 4 years can be trained to use a prescribed hand hygiene procedure that markedly reduces bacterial transmission by touch contact.


References


[1] Holmes SJ,  Morrow AL,  Pickering LK. Child-care practices: effects of social change on the epidemiology of infectious diseases and antibiotic resistance. Epidemiol Rev 1996; 18 10–28.
CAS | PubMed |

[2] Collet JP,  Burtin P,  Kramer MS,  Floret D,  Bossard N,  Ducruet T. Type of day-care setting and risk of repeated infections. Pediatrics 1994; 94 997–9.
CAS | PubMed |

[3] Wald ER,  Dashefsky B,  Byers C,  Guerra N,  Taylor F. Frequency and severity of infections in day care. J Pediatr 1988; 112 540–6.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[4] Morrow AL,  Townsend IT,  Pickering LK. Risk of enteric infection associated with child day care. Pediatr Ann 1991; 20 427–33.
CAS | PubMed |

[5] Reves RR,  Morrow AL,  Bartlett AV,  Caruso CJ,  Plumb RL,  Lu BT,, et al. Child day care increases the risk of clinic visits for acute diarrhea and diarrhea due to rotavirus. Am J Epidemiol 1993; 137 97–107.
CAS | PubMed |

[6] Hurwitz ES,  Gunn WJ,  Pinsky PF,  Schonberger LB. Risk of respiratory illness associated with day care attendance: a nationwide study. Pediatrics 1991; 87 62–9.
CAS | PubMed |

[7] Woodward A,  Douglas RM,  Graham NM,  Miles H. Acute respiratory illness in Adelaide children – the influence of child care. Med J Aust 1991; 154 805–8.
CAS | PubMed |

[8] Marx J,  Osguthorpe JD,  Parsons G. Day care and the incidence of otitis media in young children. Otolaryng Head Neck 1995; 112 695–9.
Crossref | GoogleScholarGoogle Scholar | CAS |

[9] Hardy AM,  Lairson DR,  Morrow AL. Costs associated with gastrointestinal-tract illness among children attending day-care centers in Houston, Texas. Pediatrics 1994; 94 1091–3.
CAS | PubMed |

[10] Nurmi T,  Salminen E,  Ponka A. Infections and other illnesses of children in day-care centers in Helsinki. II: The economic losses. Infection 1991; 19 331–5.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[11] Carabin H,  Gyorkos TW,  Soto JC,  Penrod J,  Joseph L,  Collet JP. Estimation of direct and indirect costs because of common infections in toddlers attending day care centers. Pediatrics 1999; 103 556–64.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[12] Fornasini M,  Reves RR,  Murray BE,  Morrow AL,  Pickering LK. Trimethoprim-resistant Escherichia coli in households of children attending day care centers. J Infect Dis 1992; 166 326–30.
CAS | PubMed |

[13] Reves RR,  Pickering LK. Impact of child day care on infectious diseases in adults. Infect Dis Clin North Am 1992; 6 239–50.
CAS | PubMed |

[14] Jiang X,  Dai X,  Goldblatt S,  Buescher C,  Cusack TM,  Matson DO, et al. Pathogen transmission in child care settings studied by using a cauliflower virus DNA as a surrogate marker. J Infect Dis 1998; 177 881–8.
CAS | PubMed |

[15] Gwaltney JMJ,  Moskalski PB,  Hendley JO. Hand-to-hand transmission of rhinovirus colds. Ann Intern Med 1978; 88 463–7.
PubMed |

[16] Hall CB,  Douglas RGJ. Modes of transmission of respiratory syncytial virus. J Pediatr 1981; 99 100–3.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[17] Butz AM,  Fosarelli P,  Dick J,  Cusack T,  Yolken R. Prevalence of rotavirus on high-risk fomites in day-care facilities. Pediatrics 1993; 92 202–5.
CAS | PubMed |

[18] Van R,  Morrow AL,  Reves RR,  Pickering LK. Environmental contamination in child day-care centers. Am J Epidemiol 1991; 133 460–70.
CAS | PubMed |

[19] Patrick DR,  Findon G,  Miller TE. Residual moisture determines the level of touch-contact-associated bacterial transfer following hand washing. Epidemiol Infect 1997; 119 319–25.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[20] Carabin H,  Gyorkos TW,  Soto JC,  Joseph L,  Payment P,  Collet JP. Effectiveness of a training program in reducing infections in toddlers attending day care centers. Epidemiology 1999; 10 219–27.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[21] Roberts L,  Jorm L,  Patel M,  Smith W,  Douglas RM,  McGilchrist C. Effect of infection control measures on the frequency of diarrheal episodes in child care: a randomised, controlled trial. Pediatrics 2000; 105 743–6.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[22] Roberts L,  Smith W,  Jorm L,  Patel M,  Douglas RM,  McGilchrist C. Effect of infection control measures on the frequency of upper respiratory infection in child care: a randomised, controlled trial. Pediatrics 2000; 105 738–42.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[23] Early E,  Battle K,  Cantwell E,  English J,  Lavin JE,  Larson E. Effect of several interventions on the frequency of handwashing among elementary public school children. Am J Infect Control 1998; 26 263–9.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[24] Master D,  Hess Longe SH,  Dickson H. Scheduled hand washing in an elementary school population. Fam Med 1997; 29 336–9.
CAS | PubMed |

[25] Luby SP,  Agboatwalla M,  Painter J,  Altaf A,  Billhimer WL,  Hoekstra RM. Effect of intensive handwashing promotion on childhood diarrhea in high-risk communities in Pakistan: a randomized controlled trial. JAMA 2004; 291 2547–54.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[26] Shahid NS,  Greenough WB,  Samadi AR,  Huq MI,  Rahman N. Handwashing with soap reduces diarrhoea and spread of bacterial pathogens in a Bangladesh village. J Diarrhoeal Dis Res 1996; 14 85–9.
CAS | PubMed |

[27] Niffenegger JP. Proper handwashing promotes wellness in child care. J Pediatr Health Care 1997; 11 26–31.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[28] Ponka A,  Poussa T,  Laosmaa M. The effect of enhanced hygiene practices on absences due to infectious diseases among children in day care centers in Helsinki. Infection 2004; 32 2–7.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[29] Black RE,  Dykes AC,  Anderson KE,  Wells JG,  Sinclair SP,  Gary GW, et al. Handwashing to prevent diarrhea in day-care centers. Am J Epidemiol 1981; 113 445–51.
CAS | PubMed |

[30] Kotch JB,  Weigle KA,  Weber DJ,  Clifford RM,  Harms TO,  Loda FA, et al. Evaluation of an hygienic intervention in child day-care centers. Pediatrics 1994; 94 991–4.
CAS | PubMed |

[31] Hall CB,  Douglas RG,  Geiman JM. Possible transmission by fomites of respiratory syncytial virus. J Infect Dis 1980; 141 98–102.
CAS | PubMed |

[32] Gwaltney JM,  Hendley JO. Transmission of experimental rhinovirus infection by contaminated surfaces. Am J Epidemiol 1982; 116 823–33.


[33] Ehrenkranz NJ. Bland soap handwash or hand antisepsis? The pressing need for clarity. Infect Control Hosp Epidemiol 1992; 13 299–301.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[34] Ehrenkranz NJ,  Alfonso BC. Failure of bland soap handwash to prevent hand transfer of patient bacteria to urethral catheters. Infect Control Hosp Epidemiol 1991; 12 654–62.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[35] Sickbert-Bennett EE,  Weber DJ,  Gergen-Teague MF,  Sobsey MD,  Samsa GP,  Rutala WA. Comparative efficacy of hand hygiene agents in the reduction of bacteria and viruses. Am J Infect Control 2005; 33 67–77.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[36] Grayson ML,  Melvani S,  Druce J,  Barr IG,  Ballard SA,  Johnson PD, et al. Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human volunteers. Clin Infect Dis 2009; 48 285–91.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |