A survey of public restrooms microbial contamination in Tehran city, capital of Iran, during 2019

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Abstract

Introduction:

Daily use of public restrooms may have a significant impact on spreading infectious diseases. Human society could be affected by spreading of transitional infectious diseases through feces, urinary tract infection and poor personal hygiene. According to the World Health Organization reports, plenty of people's developed diseases caused by contaminated public restrooms that may result in severe health problems.

Methods:

This descriptive cross-sectional study was conducted on 7,482 samples that were collected randomly in 6 months (spring and summer 2019) in different regions of Tehran. The Data were obtained by analyzing 804 restroom's indoor and outdoor handles, 1062 toilet faucet, 826 washbasin taps, 1,062 toilet hoses, 804 flush tank levers, 643 soap dispenser bottoms, 643 liquid soaps, 99 bar soaps, 169 toilet papers and paper towels, and 50 hand dryer machines. Samples which were tested, based on bacteriology standard methods.

Result:

7,482 samples were gathered of which 6,678 contaminated cases (89.25%) were observed and 804 cases (10.75%) were found non-contaminated. Escherichia coli with 28.48% and Pseudomonas with 0.39% were the most and the least common bacteria, respectively, in this study.

Conclusion:

The required tests to identify the bacteria that cause contamination through the use of public restrooms have been done. It is essential to inform the public of the mentioned items and teach how to prevent infectious diseases.

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Most cited references 16

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Microbial Biogeography of Public Restroom Surfaces

Gilberto E Flores, Scott T. Bates, Dan Knights … (2011)

We spend the majority of our lives indoors where we are constantly exposed to bacteria residing on surfaces. However, the diversity of these surface-associated communities is largely unknown. We explored the biogeographical patterns exhibited by bacteria across ten surfaces within each of twelve public restrooms. Using high-throughput barcoded pyrosequencing of the 16 S rRNA gene, we identified 19 bacterial phyla across all surfaces. Most sequences belonged to four phyla: Actinobacteria, Bacteriodetes, Firmicutes and Proteobacteria. The communities clustered into three general categories: those found on surfaces associated with toilets, those on the restroom floor, and those found on surfaces routinely touched with hands. On toilet surfaces, gut-associated taxa were more prevalent, suggesting fecal contamination of these surfaces. Floor surfaces were the most diverse of all communities and contained several taxa commonly found in soils. Skin-associated bacteria, especially the Propionibacteriaceae, dominated surfaces routinely touched with our hands. Certain taxa were more common in female than in male restrooms as vagina-associated Lactobacillaceae were widely distributed in female restrooms, likely from urine contamination. Use of the SourceTracker algorithm confirmed many of our taxonomic observations as human skin was the primary source of bacteria on restroom surfaces. Overall, these results demonstrate that restroom surfaces host relatively diverse microbial communities dominated by human-associated bacteria with clear linkages between communities on or in different body sites and those communities found on restroom surfaces. More generally, this work is relevant to the public health field as we show that human-associated microbes are commonly found on restroom surfaces suggesting that bacterial pathogens could readily be transmitted between individuals by the touching of surfaces. Furthermore, we demonstrate that we can use high-throughput analyses of bacterial communities to determine sources of bacteria on indoor surfaces, an approach which could be used to track pathogen transmission and test the efficacy of hygiene practices.

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The Effect of Handwashing with Water or Soap on Bacterial Contamination of Hands

Maxine Burton, Emma Cobb, Peter Donachie … (2011)

Handwashing is thought to be effective for the prevention of transmission of diarrhoea pathogens. However it is not conclusive that handwashing with soap is more effective at reducing contamination with bacteria associated with diarrhoea than using water only. In this study 20 volunteers contaminated their hands deliberately by touching door handles and railings in public spaces. They were then allocated at random to (1) handwashing with water, (2) handwashing with non-antibacterial soap and (3) no handwashing. Each volunteer underwent this procedure 24 times, yielding 480 samples overall. Bacteria of potential faecal origin (mostly Enterococcus and Enterobacter spp.) were found after no handwashing in 44% of samples. Handwashing with water alone reduced the presence of bacteria to 23% (p < 0.001). Handwashing with plain soap and water reduced the presence of bacteria to 8% (comparison of both handwashing arms: p < 0.001). The effect did not appear to depend on the bacteria species. Handwashing with non-antibacterial soap and water is more effective for the removal of bacteria of potential faecal origin from hands than handwashing with water alone and should therefore be more useful for the prevention of transmission of diarrhoeal diseases.

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Outbreak of Serratia marcescens in a neonatal intensive care unit: contaminated unmedicated liquid soap and risk factors.

A Beuchée, P Pladys, S. Buffet … (2009)

This study describes an outbreak of Serratia marcescens and its investigation and control in a neonatal intensive care unit (NICU). During a three-month period, five infants were colonised or infected by a single strain of S. marcescens. A case-control study, culture surveys and pulse-field gel electrophoresis analysis implicated a bottle soap dispenser as a reservoir of S. marcescens (P=0.032). Infants with S. marcescens colonisation or infection were also more likely to have been exposed to a central or percutaneous venous catheter (P=0.05) and had had longer exposure to endotracheal intubation (P=0.05). Soap dispensers are used in many hospitals and may be an unrecognised source of nosocomial infections. This potential source of infection could be reduced by using 'airless' dispensers which have no air intake for the distribution of soap. Prompt intervention and strict adherence to alcoholic hand disinfection were the key factors that led to the successful control of this outbreak.

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Author and article information

Journal

Journal ID (nlm-ta): J Family Med Prim Care

Journal ID (iso-abbrev): J Family Med Prim Care

Journal ID (publisher-id): JFMPC

Title: Journal of Family Medicine and Primary Care

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 2249-4863

ISSN (Electronic): 2278-7135

Publication date Collection: June 2020

Publication date (Electronic): 30 June 2020

Volume: 9

Issue: 6

Pages: 3131-3135

Affiliations

[1 ] Department of Medical, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran

[2 ] Department of Paramedicine, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran

[3 ] Department of Modern Science, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran

[4 ] Department of Basic Science, Islamic Azad University, Science and Research Branch, Tehran, Iran

[5 ] Department of Paramedicine, Varastegan Private University, Mashhad Medical Sciences Branch, Tehran, Iran, India

Author notes

Address for correspondence: Dr. Javad Nematian, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran. E-mail: nematian@ 123456gmail.com

Article

Publisher ID: JFMPC-9-3131

DOI: 10.4103/jfmpc.jfmpc_300_20

PMC ID: 7491804

SO-VID: 4473db27-95fe-4b0e-a47f-b659e1140861

License:

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

History

Date received : 22 February 2020

Date revision received : 14 March 2020

Date accepted : 25 April 2020

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A survey of public restrooms microbial contamination in Tehran city, capital of Iran, during 2019

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Abstract

Introduction:

Methods:

Result:

Conclusion:

Related collections

Microbial Genomics

Most cited references 16

Microbial Biogeography of Public Restroom Surfaces

The Effect of Handwashing with Water or Soap on Bacterial Contamination of Hands

Outbreak of Serratia marcescens in a neonatal intensive care unit: contaminated unmedicated liquid soap and risk factors.

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Cited by 2

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