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A study published online in Proceedings of the National Academy of Sciences suggests that health care workers, such as radiologists and physical therapists, may play a disproportionate role in spreading hospital-acquired infections (HAIs), suggesting the need for hospitals to evaluate hand-hygiene compliance "individually, rather than globally," MedPage Today reports. To identify those who spread HAIs, a researcher from the Conservatoire des Arts et Métiers in Paris and colleagues used a mathematical model to track the effects of neglecting hand-washing protocols among three types of health care workers grouped by their degree of interaction with patients. The three groups were identified as those with frequent contact with a limited number of patients, such as nurses; those with infrequent contact with a large number of patients, such as physicians; and those with daily contact with all patients, such as physical therapists and radiologists. The model simulated the introduction of a single colonized patient to an 18-bed hypothetical intensive care unit that was previously free of studied pathogens and tracked effects during one month, assuming patients would remain in the hospital for an average of 10 days. When all health care workers washed their hands, the model predicted between 1.5 and 5.8 new cases of infection, on average, over the month-long period. However, if a single worker neglected hand-washing, predicted cases of infection rose to 1.7 to 6.8 cases, on average, during the month. The results were "highly dependent" on the type of worker who failed to comply with hand hygiene, according to MedPage Today. Specifically, when a noncompliant worker such as a physician failed to wash his or her hands, the increase in predicted HAI cases ranged from 2 percent to 7 percent, while the increase ranged from 73 percent to 238 percent for a noncompliant worker such as a radiologist, leading researchers to conclude that such workers, deemed peripatetic workers by researchers, may play a "disproportionate role in disseminating pathogens in a hospital ward." Commenting on the findings, the lead researcher suggests that measuring hand hygiene compliance with indicators such as overall use of hand rub products may not be an accurate indicator of the risk of spreading HAIs. The authors recommend that hospitals evaluate hand-washing compliance on an individual basis (Smith, MedPage Today, 10/16/09; Doheny, HealthDay, 10/19/09; Temime et al., Proceedings of the National Academy of Sciences, 10/19/09 [subscription required]).