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During care, healthcare professionals may be exposed to infectious risks through contact, projection, aerosolisation of biological fluids including blood if the protective devices are inadequate or defective (professional clothing, gloves, goggles).

This contamination can also be percutaneous by inoculation (puncture or cut)1 .

 

What are healthcare-associated infections (HAIs)?

A healthcare associated infection occurs at the beginning or end of a patient’s care (diagnostic, therapeutic, palliative, preventive, educational, surgical) performed by a healthcare professional, whether in a health care institution, a medico-social institution or at the patient’s home.

These infections may be directly related to care (for example, during an invasive procedure) or may occur during hospitalization, during the stay, independently of any medical procedure (in case of an epidemic episode). When the patient’s infectious state on admission is unknown, the infection is classically considered an HAI if it appears after 48 hours of hospitalization.2

Where do HAIs come from?

Healthcare-associated infections have multiple origins. There are several types of infections:

  • Infections of “endogenous” origin: the patient is infected with his own germs because of an invasiveact and/or because of a particular
  • Infections of “exogenous” origin: cross-infections, transmitted from one patient to another, infections transmitted by staff or infections linked to the contamination of the environment in which the patient is

These HAIs can be caused by several types of microorganisms: in France,  31.2% are multi-resistant bacteria (MRB), 25% are highly resistant emerging bacteria (HREB) and 15.3% are Clostridium difficile3 . The resistance of these bacteria to antibiotics has become a major public health issue, as it is responsible for 700,000 deaths per year worldwide5 .

 

In addition, other micro-organisms are also responsible for healthcare-associated infections:

  • Fungi : These are responsible for widespread infections and represent a major global health problem with 2 million people becoming ill each year.4
  • Virus: A virus is an infectious microscopic particle that can only replicate itself by entering a cell and using its cellular machinery (production/reproduction mechanism).

HAIs, which sources of propagation?

These HAIs also fall under different transmissions including contact transmission (C).

The latter can be through direct contact (by the hands of staff or between patients) or indirect contact (contaminated objects or surfaces). Hands are a vector for a very large number of pathogenic microorganisms and are therefore considered to be the main source of the spread of infections.

What can be done to prevent contact infections?

To control infectious risks, two solutions are available to healthcare professionals:

 

1. Hand hygiene

Since the Covid-19 pandemic, hand disinfection has increased in the health sector but has also spread widely outside the medical sector. Hand disinfection is an action aimed at eliminating undesirable micro-organisms such as bacteria, viruses and fungi present on the skin. Hydroalcoholic gels or solutions have the same objective, to destroy micro-organisms present on the hands, thus limiting the transmission of certain infections. These are used when no access to water is available and have become essential in the fight against Covid-19 and in barrier practices.

 

2. Wearing gloves

This solution is key to avoid contamination, including accidents involving exposure of caregivers to blood and other biological fluids (AEB), and to prevent the hand-carried transmission of infectious agents between the healthcare professional, the patient and the healthcare environment:

  • In case of contact with or splashing of biological fluids
  • For all contact with the patients skin
  • When the healthcare professional’s hands have skin lesions

It is important to use gloves in a health care environment that have both Medical Device (MD) and Personal Protective Equipment (PPE) certification.

 

The use of gloves to prevent infections

Protective gloves are used in health care facilities, nursing homes and home care facilities for many applications.

 

 

Gloves are also needed when handling or touching potentially infected objects or surfaces. Single-use medical gloves therefore create a barrier between the healthcare professionals hands and blood, body fluids, secretions, excretions and mucous membranes.7

In addition, gloves limit the exposure of healthcare professionals to chemical risks (disinfectant, reagent, chemotherapy molecule).

 

The gloves are single-use and do not exclude hand washing and disinfection.

These two actions are complementary and can be completed by the use of hydroalcoholic friction solutions (hygienic and surgical friction). Upstream disinfection reduces the initial risk of hand   contamination, which can be increased under gloves by heat and humidity.7

Allergic risks

Reactions to gloves

Sources:

[1] Hygiènes – Actualisation des précautions standard, juin 2017 – N° hors-série volume XXV

[2] Santé.gouv : https://solidarites-sante.gouv.fr/soins-et-maladies/qualite-des-soins-et-pratiques/securite/infections-associees-aux-soins-ias/article/les-infections-nosocomiales-318585

[3]  Sylvie Maugat et all., « Bilan 2001-2017 des signalements externes d’infections nosocomiales. Part des signalements impliquant une bactérie multi résistante, hautement résistante-émergente ou un clostridium difficile », article soumis le 30.11.2017

[4] https://www.pasteur-lille.fr/actualites/dossier-du-mois/les-medicaments/les-medicamentscontrer-resistance-antibiotiques-defi-scientifique/

[5] https://www.medecinesciences.org/en/articles/medsci/full_html/2018/02/medsci20183402p123/medsci20183402p123.html

[6] Hygiènes – Actualisation des précautions standard, juin 2017 – N° hors-série volume XXV

[7] Institut national de Recherche et de Sécurité (INRS). Gants de protection pour les métiers de la santé, fiche ED 118. [En ligne]. INRS 2004. Disponible sur : http://www.inrs.fr