Cross-Correlation Analysis of the Incidence of Multidrug-Resistant Organisms with Hand Hygiene Compliance and Effectiveness of Alcohol-Gel Hand Hygiene Practice

Eun-Hwa Baek1   Se-Eun Kim1   Da-Hye Kim1   Sunjoo Kim23*   

1 Infection Control Team, Gyeongsang National University Changwon Hospital, Changwon,
2 Department of Laboratory Medicine, Gyeongsang National University Changwon Hospital, Changwon,
3 Institute of Health Science Gyeongsang National University, Jinju,

* Corresponding author: Tel: +82-55-214-3072, Fax: +82-55-214-3087, E-mail:


Background: Multidrug- resistant organisms (MDRO) are a serious concern in healthcare-associated infections. Hand hygiene (HH) is essential to prevent the spread of MDRO in the healthcare institutes. The aim of this study was to investigate the relationship between the incidence of MDRO and hand hygiene compliance and the experimental effectiveness of alcohol-gel hand hygiene practice.

Methods: From March 2016 to September 2018, we analyzed the cross-correlation between the incidence of MDRO and the HH compliance each month at Gyeongsang National University Changwon Hospital. We employed an experiment to observe the effect of alcohol gel hand hygiene practice on the reduction of organisms on the hand surface using the hand-agar plates.

Results: Among the MDRO, only vancomycin-resistant enterococci (VRE) showed a moderate correlation with the HH rate (r = 0.55). The hand-agar plate experiment showed a significant bacterial reduction for inadequate HH (mean 3.47 CFU) and optimal HH (mean, 0.84 CFU) than before HH (mean, 11.56 CFU) (n = 32, P = 0.006).

Conclusion: The incidence of VRE showed a moderate correlation with HH among MDRO in the longitudinal analysis. HH practice was more effective in preventing the spread of VRE compared with other MDRO in our institute. Optimal alcohol-gel HH practice can effectively remove bacteria on the hand surface.

Figures & Tables

Fig.1. Incidence of MRAB (multidrug-resistant Acinetobacter baumannii), VRE (vancomycin-resistant enterococci), CRE (carbapenem-resistant Enterobacteriacecae), MRSA (methicillin-resistant Staphylococcus aureus), MRPA (multidrug-resistant Pseudomonas aeruginosa) and hand hygiene (HH) compliance. Incidence is defined as new cases per 1,000 patient days.