International Journal of Research in Medical Sciences | December 2021 | Vol 9 | Issue 12 Page 3534 International Journal of Research in Medical Sciences Alçi G et al. Int J Res Med Sci. 2021 Dec;9(12):3534-3540 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Original Research Article Hand hygiene compliance of health care workers in a neonatal intensive care unit: a prospective observation study Gamze Alçi 1 , Hulya Bilgen 2 , Eren Özek 2 , Ayşegül Karahasan Yagci 1 * INTRODUCTION Hospital-acquired infections (HAIs) increase morbidity and mortality of the patients, prolong hospital stay and thus increase costs. 1,2 Microorganisms that are known to be the cause of hospital infection are transmitted to the hands of healthcare workers (HCWs) during direct contact with patients or contact with surrounding areas and are carried in the temporary flora of their hands. Despite the relative simplicity and the effectiveness of this procedure, HAIs continue to be one of the greatest challenges and continuous surveillance remains the mainstay to follow compliance. 3 HAIs persist as a major problem in most neonatal intensive care units (NICU). Neonates are susceptible to infection due to their immature host defence and they also occupy an environment in which frequently used antibiotics and invasive interventions often permit the invasion of common nosocomial pathogens. The most common infections are ventilator-associated pneumonia and bloodstream infections. 4 In developing countries the incidence rate of HAIs ranges from 6 to 9%. 5,6 The incidence of HAI was reported 4.9% to 16.4% in Turkey. 7,8 1 Department of Medical Microbiology, 2 Department of Pediatrics, Division of Neonatology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey Received: 08 October 2021 Revised: 02 November 2021 Accepted: 08 November 2021 *Correspondence: Dr. Ayşegül Karahasan Yagci, E-mail: aysegulkarahasan@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: We aimed to determine hand hygiene (HH) compliance of the healthcare workers (HCW’s) and evaluate if there is an epidemiological relation between the microorganisms isolated from the hands of HCWs and patients clinical materials in the neonatal intensive care unit (NICU). Methods: HH compliance was observed in two unannounced phases in March and in August within the scope of 5 indications determined by WHO. Between two phases personnel was trained to improve HH by educational sessions and introduction of Semmelweis system hand in scan (HIS, Sysmex) in the unit. A total of 22 nurses, 11 physicians and 5 staff was working in the NICU. Hand samples taken from HCW by glove juice method were inoculated quantitatively in culture plates and colonies were identified by MALDI-TOF MS. Epidemiological relation between clinical isolates and hand samples was investigated with arbitrary primed PCR. Results: Although overall compliance remained only 50%, a significant increase in compliance was detected in August prior to aseptic procedures and after contact with patients and body fluids. Alcohol scrub was preferred as 60.4% in March and 75.2% in August. HH efficacy reached to 72% by implementing HIS. During this period, 10.7% of 607 patient’s samples revealed clinically significant growth. Potential pathogens were isolated in 5.2% of 144 hand samples, but any epidemiological correlation with patient isolates was detected. Conclusions: HH compliance observations should be done at regular intervals and current technology could be utilized in trainings to overcome hospital related infections. Keywords: AP-PCR, Gloves juice method, Hand hygiene, Neonatal intensive care unit DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20214703