Prevalence and antimicrobial susceptibility pattern of gram- negative bacteria contaminating the hands of patients’ visitors at regional referral hospitals in Dar-es-Salaam: A hospital based cross sectional study

Background Hand contamination by bacteria is a significant source of infection transmission, especially in hospital settings. A healthcare-associated infection is one that a person contracts as a result of their interaction with a hospital. Health care workers’, patients’ and visitors’ hands are all transmission routes for infections, in particular bacterial infections. These infections elevate the economic burden on healthcare systems especially in low-income settings. The purpose of this study is to determine the prevalence of gram-negative bacteria hand contamination among patients’ visitors of referral hospitals in Dar es Salaam. Results Prevalence of gram-negative bacterial contamination on visitors’ hands was 91 (21.1%) on entry and 103 (30.2%) on exit. The most common bacteria contamination was from Klebsiella pneumoniae on both entry and exit points, 37 (41%) and 57 (43%) respectively. Resistance to cephalosporins (Cefotaxime and Ceftriaxone) were the most pronounced. Proportion of ESBL-producing bacteria was significantly higher at exit than at entry. Bacterial contamination was associated with not washing hands APR = 1.5 (95% CI:1.03–2.17), offering services to the patient APR = 1.9 (95% CI:1.21–2.87) and longer hospital stays (more than 7 days) APR = 1.5 (95% CI:1.1-2.0). Conclusion To prevent the transmission of bacteria, it is important to emphasize hand hygiene and exposure limits for visitors entering hospital environments.