Healthcare-associated infections and bacterial resistance are some of the biggest public health challenges of our time. When it comes to the transmission of micro-organisms, hands are important agents and poor hand hygiene causes millions of infections every year. The importance of hand hygiene can therefore never be underestimated.

Healthcare-associated infections (HAIs) are increasingly a concern to the general public, regulatory agencies and the insurance industry. This is not only due to the significance of the problem in regard to morbidity, mortality and the economic burden of HAIs but also because of the fact that many of them are reasonably preventable [1]. Around 1 in 10 people will develop a HAI while being admitted to a hospital and with the rise of antibiotic resistance, HAIs are becoming more of a challenge [2]. It is estimated that by 2050, more people will die from drug-resistant infections than from cancer and road traffic accidents combined [3]. Reducing the risk of infection transmission is therefore essential.

The many faces of HAIs

HAIs can be caused by bacteria, fungi and viruses. Bacteria alone causes around 90% of all HAIs. Some of the commonly responsible microbes that can be spread on the hands of healthcare professionals are [4,5]:

  • Staphylococcus aureus
  • Enterococci
  • Streptococcus pyogenes
  • Vancomycin-resistant Enterococcus
  • Klebsiella
  • Enterobacter
  • Pseudomonas
  • Clostridium difficile
  • Candida
The chain of infection

An example for a simple chain of infection is a healthcare worker who doesn’t conduct proper hand hygiene after taking care of an infected patient and is then caring for another patient [6]. But spread of infection does not necessarily occur due to direct person-to-person contact. Organisms can also be present on contaminated objects such as medical instruments or doorknobs. Once touched, microbes can be transferred on to the healthcare professional hands and infect the patient. Even after seemingly “clean” contact like taking a patient’s pulse, temperature or blood pressure, bacteria have been found on the hands of personnel [7]. No matter the scenario, hands are important agents [MH1] [MS2] when it comes to the transmission of micro-organisms and multiple studies have shown that microbes can survive on hands for long periods if they are not cleaned properly [8].

The importance of hand hygiene in infection control

Already in the early 19th century, the importance of hand hygiene in patient care was conceptualized and the first evidence was provided that hand decontamination can distinctly reduce the occurrence of puerperal fever and maternal death [9]. In subsequent decades, scientific research has confirmed the key role of hand hygiene in avoiding transmission of pathogens in hospitals and reports a correlation between improved hand hygiene and the reduction of infection as well as cross-transmission [10]. Adherence to hand hygiene practices contributes significantly to keeping patients safe and is more important than ever with the emerging threat of multidrug-resistant pathogens that are becoming difficult, if not impossible, to treat. There is undisputed evidence for the importance of hand hygiene to prevent infection. It is a simple and low-cost action that reduces the rates of acquisition of pathogens on hands significantly [11].


[1] Hand hygiene: Back to the basics of infection control Purva Mathur Indian J Med Res. 2011 Nov; 134(5): 611–620. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/
[2] https://www.ausmed.com/cpd/articles/hand-hygiene
[3] https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf
[4] https://www.ausmed.com/cpd/articles/hand-hygiene
[5] https://www.who.int/gpsc/tools/faqs/evidence_hand_hygiene/en/
[6] https://www.infectioncontroltoday.com/hand-hygiene/breaking-chain-infection
[7] https://www.healio.com/infectious-disease/nosocomial-infections/news/print/infectious-disease-news/%7Bdd1e115b-8a00-4889-9e85-8566391f2541%7D/infection-prevention-in-hospitals-the-importance-of-hand-hygiene
[8] https://www.who.int/gpsc/tools/faqs/evidence_hand_hygiene/en/
[9] Hand hygiene: Back to the basics of infection control Purva Mathur Indian J Med Res. 2011 Nov; 134(5): 611–620. Available from: ­https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/
[10] https://www.ausmed.com/cpd/articles/hand-hygiene
[11] Hand hygiene: Back to the basics of infection control Purva Mathur Indian J Med Res. 2011 Nov; 134(5): 611–620. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/