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. 2023 Mar 15;12(3):583.
doi: 10.3390/antibiotics12030583.

Hand Hygiene and Antimicrobial Resistance in the COVID-19 Era: An Observational Study

Antonino Russotto  1 , Edoardo Rolfini  1 , Giovanni Paladini  1 , Claudia Gastaldo  1 , Costanza Vicentini  1 , Carla Maria Zotti  1
Affiliations

Hand Hygiene and Antimicrobial Resistance in the COVID-19 Era: An Observational Study

Antonino Russotto et al. Antibiotics (Basel). .

Abstract

Hand hygiene (HH) is one of the most important infection prevention and control strategies at the hospital level. The aim of this study was to evaluate the potential COVID-19 pandemic impact on HH practices and rate of healthcare-associated infections. Data on alcohol-based handrub consumption (AHC) and antimicrobial resistance across 27 Italian hospitals over the period 2017-2021 were considered. Data on Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteria (CRE) were extracted from the antimicrobial resistance regional surveillance system. A significant increase was highlighted, with a peak in 2020 and a partial fall in 2021 for AHC (p < 0.001). The decrease in MRSA rates in 2021 compared to 2017-2019 was significant (p = 0.013). A significant Spearman's correlation between AHC and CRE rates was found (Spearman's ρ -0.646, p = 0.032). This study supports the importance of AHC monitoring and showed that improving AHC was an attainable goal in the COVID-19 era. However, other strategies are needed to maintain the high levels of AHC attained during the pandemic, in order to avoid a progressive drop that has already begun in 2021. Furthermore, our results support the inverse relationship between AHC and infection rates and antimicrobial-resistant bacteria.

Keywords: COVID-19; Italy; antimicrobial resistance; hand hygiene; healthcare-associated infections; infection control.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Median alcohol-based handrub consumption (AHC, liters/1000 patient-days) among 27 hospitals in Piedmont, 2017–2021.
Figure 2
Figure 2
Median methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteria (CRE) rates among invasive isolates from 27 hospitals in Piedmont, 2017–2021.
Figure 3
Figure 3
Cross−correlation between alcohol-based handrub consumption (AHC) and methicillin-resistant Staphylococcus aureus (MRSA) rate at the hospital level.
Figure 4
Figure 4
Cross−correlation between alcohol-based handrub consumption (AHC) and carbapenem-resistant Enterobacteria (CRE) rate at the hospital level.
See this image and copyright information in PMC

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