Close the lid before you flush?

Photo:  Eljer Toilet Seats

A new study in the Journal of Hospital Infection evaluates what happens when a toilet that contains Clostridium difficile is flushed. Using air sampling and settle plates placed around the toilet, the investigators determined that the organism is aerosolized by the flush and could be found on most of the settle plates. Interestingly, if the toilet lid were closed prior to flushing, C. difficile could not be recovered from any of the settle plates. Unfortunately, hospital toilets typically don't have lids, and the investigators recommend that hospital toilets should be fitted with lids. However, this would mean that the undersurface of the lids would quickly become contaminated, which could also cause problems.

There's an old pearl bantered about by infectious diseases doctors that the world is covered with a thin veneer of stool. This study and the one I blogged about a few weeks ago surely provide proof of that.

In case you need another reminder to wash your hands...

Photo: Medical Tips Blog

There's a new paper in PLoS One on the biogeography of public restrooms (full text here). In other words, some investigators cultured various surfaces in 12 bathrooms on a university campus and then mapped out areas where groups of bacteria (e.g., skin flora, gut flora, genitourinary tract flora, and soil organisms) were found. The results were quite predictable. Soil organisms were dominant on floor surfaces (brought in via shoes), skin organisms dominated on faucets, and fecal organisms dominated on toilet surfaces. Of note, toilet flush handles were found to harbor both fecal organisms and soil organisms, and the authors postulate that the soil organsims are deposited there when people flush toilets with their feet in order to avoid touching the flush handle with their hands.

Ironically, one of the sponsors of the study was the Howard Hughes Medical Institute, the foundation started by an infamous germophobe.

So for all of you using the bathroom in an airport, train or bus station on this Thanksgiving eve:  Wash your hands! And turn off the faucet with a paper towel.

Bathrooms and Infections

Maryn Mckenna (Colin Purrington started the meme) has an nice post on bathroom design and infection risk on her SuperBug blog.  One thing I was not aware of was that hot air hand dryers "pull air from the bathroom floor, not from the outside, so all they’re doing is shooting a blast of hot bacteria full force onto your hands. One study showed that using electric dryers increased bacteria levels on hands by 162 percent.”  It's all pretty scary.  I think alcohol hand rub is the answer.  I like how O'Hare airport in Chicago has alcohol hand rub dispensers just outside each bathroom.

Oh, if you like the signs on the hot air dryer and door, just download Purrington's door signage and hand dryer signage files (PDFs) and print onto 4 x 6″ 3M removable adhesive labels (#6200). Thanks Colin and Maryn!