Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/80786
Title: The public washroom - friend or foe? An observational study of washroom cleanliness combined with microbiological investigation of hand hygiene facilities
Authors: Suen, LKP 
Siu, GKH 
Guo, YP 
Yeung, SKW 
Lo, KYK 
O'Donoghue, M 
Keywords: Washroom
Environmental microbiology
MALDI-TOF MS
Hand hygiene
Antimicrobial
Bacteria
Microorganisms
Public health
Toilet
Hand drying
Issue Date: 28-Feb-2019
Publisher: BioMed Central
Source: Antimicrobial resistance and infection control, 28 Feb. 2019, v. 8, 47, p. 1-6 How to cite?
Journal: Antimicrobial resistance and infection control 
Abstract: Background: Many people use handwashing and hand-drying facilities in public washrooms under the impression that these amenities are hygienic. However, such facilities may be potential sites for the transmission of pathogenic bacteria. This study aimed to examine the hygiene facilities provided including handwashing and hand-drying facilities in public washrooms. Total bacterial counts and species identification were determined for hand-drying facilities. Antimicrobial susceptibilities were performed.
Methods: The high and middle-income categories washrooms generally had cleaner facilities and environment followed by those in low categories. Fifty-two bacterial species were identified from the 55 investigated washrooms. Over 97% of the pathogenic Staphylococcus spp. tested were resistant to at least one first-line antimicrobial therapeutic agent, including penicillin, cefoxitin, erythromycin, co-trimoxazole, clindamycin and gentamicin, and 22.6% demonstrated co-resistance to at least three antimicrobial agents, with co-resistance to penicillin, erythromycin and clindamycin being the most common.
Results: The high and middle-income categories washrooms generally had cleaner facilities and environment followed by those in low categories. Fifty-two bacterial species were identified from the 55 investigated washrooms. Over 97% of the pathogenic Staphylococcus spp. tested were resistant to at least one first-line antimicrobial therapeutic agent, including penicillin, cefoxitin, erythromycin, co-trimoxazole, clindamycin and gentamicin, and 22.6% demonstrated co-resistance to at least three antimicrobial agents, with co-resistance to penicillin, erythromycin and clindamycin being the most common.
Conclusion: Our findings suggest that hand-drying facilities in public washrooms can act as reservoirs of drug-resistant bacteria. The importance of frequent cleaning and maintenance of public washrooms to promote safe hand hygiene practices for the public are emphasised.
URI: http://hdl.handle.net/10397/80786
EISSN: 2047-2994
DOI: 10.1186/s13756-019-0500-z
Rights: © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The following publication Suen, L. K. P., Siu, G. K. H., Guo, Y. P., Yeung, S. K. W., Lo, K. Y. K., & O’Donoghue, M. (2019). The public washroom-friend or foe? An observational study of washroom cleanliness combined with microbiological investigation of hand hygiene facilities. Antimicrobial Resistance & Infection Control, 8, 47, 1-6 is available at https://dx.doi.org/10.1186/s13756-019-0500-z
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