Published: 2020-04-24

A knowledge, attitude and practice study on hand hygiene and antibiotic susceptibility pattern in isolates of pathogens from hands in school children

V. Harika, Swarajya Lakshmi Mekala, Fatima Amatullah, Sandeep Kumar Tipparthi, K. Sugunakar Reddy


Background: Estimates in India indicate that gastrointestinal infections and respiratory infections are the most common childhood killer diseases. Infectious germs on hands are the commonest way that children spread infections. Present study mainly focused on creating awareness (by practical demonstration) about importance of hand hygiene in school children, which is one of the simplest, low cost and most advisable form of the infection prevention and transmission.

Methods: In a school of semi-rural setting, 300 swabs before and after hand wash (with a liquid soap) were collected randomly from dominant hands of 150 students of age group 5-13 years and then transported to laboratory for further processing.

Results: Hands of 96.7% students were found to harbor bacteria before handwash which included Micrococcus (60.6%), CONS (6.6%), Neisseria spp. (31.3%), Bacillus spp. (26%), Diphtheroids (9.3%), and potential pathogens like Staphylococcus aureus (16.6%), Klebsiella spp. (2.6%), Escherichia coli (2%). Data indicates that hands of female students are more contaminated than male. There is evidence of 58% reduction in the bacterial flora after hand wash.

Conclusions: It has been clearly demonstrated by an orientation programme to all students with results that the initial step in chain of infection can be controlled by proper hand wash technique to prevent communicable diseases and reduce the use of antibiotics.


Hand wash, Infections, Maheshwara Medical College and Hospital, School children, Swab

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PTI. 16.8 lakh children under five in India died of infectious diseases in 2010. The Hindu. New Delhi; 2012.

Mandlik RM, Chiplonkar SA, Khadilkar VV, Phanse-Gupte S, Mughal ZM, Patwardhan VG, et al. Prevalence of infections among 6-16 years old children attending a semi-rural school in Western Maharashtra, India. Indian J Child Health. 2015;2(4):182-6.

Park K. Park’s Textbook of preventive and social medicine. 23rd ed. India: Bhanot Publishers; 2015: 153.

Larson E. Skin hygiene and infection prevention: more of the same or different approaches? Clin Infect Dis. 1999;29(5):1287-94.

Shrestha A, Angolkar M. Improving hand washing among school children: an educational intervention in South India. Al Ameen J Med Sci. 2015;8:81-5.

World Health Organisation. Evidence of hand hygiene to reduce transmission and infections by multi-drug resistant organisms in health-care settings. Available at: 5may/MDRO_literature-review.pdf. Accessed on 05 May 2019.

Shrestha A, Angolkar M. Impact of health education on the knowledge and practice regarding personal hygiene among primary school children in urban area of Karnataka, India. IOSR J Dent Med Sci. 2014;13(4):86-9.

Garg A, Taneja DK, Badhan SK, Ingle GK. Impact of a school-based hand washing promotion program on knowledge and hand washing behaviour of girl students in a middle school of Delhi. Indian J Public Health. 2013;57:109-12.

Monnet DL, Sprenger M. Hand hygiene practices in healthcare: measures and improve. Euro Surveill. 2010;17(18):20166.

Tambekar DH, Shirsat SD. Hand washing: a cornerstone to prevent the transmission of diarrhoeal infection. Asian J Med Sci. 2009;1(3):100-3.

Ray SK, Amarchand R, Srikanth J, Majumdar KK. A study on prevalence of bacteria in the hands of children and their perception on hand washing in two schools of Bangalore and Kolkata. Indian J Public Health. 2011;55(4):293-7.

Edmonds-Wilson SL, Nurinova NI, Zapka CA, Fierer N, Wilson M. Review of human hand microbiome research. J Dermatol Sci. 2015;80(1):3-12.

Ojajärvi J. Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing. Epidemiol Infect. 1980;85(2):193-203.

Tambekar DH, Shirsat SD. Role of hand washing and factors for reducing transmission of entericinfections among students of Amaravati district. Sci Res Report. 2013;3(2):175-82.

Zapka CA, Cambell EJ, Maxwell SL, Gerba CP, Dolan MJ, Arbogast JW, et al. Bacterial hand contamination and transfer after use of contaminated bulk-soap-refillable dispensers. Applied Environ Microbiol. 2011;77(9);2898-904.