One essential element in preventing the spread of infection is practicing good hand hygiene [2]. It is acknowledged that encouraging better hand hygiene is a crucial public health intervention. There is a lot of focus on how to wash your hands properly, but not as much on how to dry them. According to evidence, hand drying effectiveness plays a significant role in preventing the spread of microorganisms from one person to another or to the environment [1].

Numerous microorganisms reside as commensals on the surface of normal human skin, colonizing it [2]. Microorganisms that are not typically present there can occasionally colonize the epidermis and cause illness quickly. Numerous organisms that are unable to proliferate but happen to land on the skin include these harmful pathogens. It can occasionally be colonized by organisms that aren't typically thought of as skin flora. It is frequently challenging to identify whether an isolated organism is causing or contributing to the apparent pathology when the skin is irritated or aberrant. Microorganisms that are typically thought of as non-pathogenic on the surface of the body may become opportunist pathogens if the subject's skin is damaged or their immune system is compromised. Within a specific species, there are also strain differences in virulence [2].

Pathogenic microorganisms may spread through the hands. The microbial flora of the skin has been the focus of numerous researches, some of which are rather extensive and in-depth. The role of hand drying chemicals and procedures in the development of human disease has been the subject of relatively few studies. Paper towels, continuous roller towels (where a fresh area of towel is available for each user), and warm air dryers were the three main hand drying methods available in public restrooms until fairly recently. This is ignoring the types of textile towels that have been condemned for many years on the basis of hygiene, as they allow users to dry their hands on the same area of material as previous users [3].

Skin microbes are typically classified as either pathogens, prospective pathogens, or harmless symbiotic organisms. Our knowledge of the molecular mechanisms of microbial virulence and the particular events involved in the host–microbe interaction is being updated by developments in immunology and microbiology. Some historical classifications of cutaneous microbiota are contradicted by current data, which characterize these organisms as mutualistic rather than symbiotic and suggest that they may protect the host. Current knowledge on bacterial skin flora, such as Streptococcus, Pseudomonas, Propionibacterium, Corynebacterium, and Staphylococcus, will be compiled in this review. Specifically, the review will cover our present understanding of the cutaneous microbiota as well as altering paradigms in the interpretation of the role’s microorganisms play in skin health and disease and also it transmission in public place [4].

Since Semmelweiss's 19^th century observations regarding the impact of hand washing on the prevalence of puerperal fever in a maternity ward, proper hand hygiene has been acknowledged as a critical component in preventing the spread of infectious diseases and, more recently, bacteria resistant to antibiotics in hospitals and the community [3].

Paper or cloth towels, warm air dryers, or jet air dryers, either separately or in combination, are just a few of the many different hand drying techniques. While moisture is wicked away into the absorbent material, drying with towels may eradicate any leftover microorganisms through friction. During hand rubbing, warm air dryers eliminate some microorganisms and evaporate moisture, but this process may take too long to be effective, leaving hands damp [5]. A variety of considerations, such as cost, space availability, practicality, or personal preference, may influence the drying technique choice. The choice of hand-drying technique may be influenced by infection prevention considerations, but there is not enough data to make an informed choice [1].

Various restaurants were selected for the study and to assess the microorganism species found in the hand towels in the establishments based on the issues statement [6]. Studies have looked at the skin flora of both healthy and sick people in an effort to determine whether there is a connection between sickness and the skin's microbial flora [7]. We intended to investigate the types of microorganisms that colonized hand towels in several Ekpoma restaurants [8].

MATERIALS AND METHODS

Study Area

This study was conducted from five (5) different communities (Ihumudumu, Ujoelen, Idumebo, Ukhun, and Ujemen) in the semi-urban town of Ekpoma, Esan West Local Government Area of Edo State, Nigeria. Edo State, which has a population of 3.1 million and is situated in the South-South geopolitical zone of Nigeria, between longitudes 06^o 04^IE and 06^o 43^IE and latitudes 05^o 44^IN and 07^o 34^IN.

Study Population / Sample Size

Ekpoma restaurants were chosen at random to participate in this study. For this study, fifty (50) hand towels were chosen at random, and ten (10) eateries from five distinct Ekpoma communities-Ihumudumu, Ujoelen, Idumebo, Ukhun, and Ujemen-were included. Samples were obtained by cotton swab from the hand towels of different eateries. Swabs were cultivated on various Nutrient agar and incubated at 37°C and sub-cultured into suitable agars. Moreover, different biochemical tests were applied; catalase test, coagulase test and oxidase test. Differential biochemical, microscopic, and macroscopic assays were used to identify microorganisms. In contrast to fast food, restaurants that employ serviette papers, hand basins, and hand dryers were not included in this survey; only restaurants that use hand towels were.

Study Design

This study was a descriptive/analytical study. It was meant to examine the microbial flora of hand towels used in Ekpoma restaurants. Specimens such as hand towel swab were collected and tested in the laboratory using standard methods. Results were reported in tables.

Specimen Collection

For this investigation, fifty (50) hand towels from various restaurants in five (5) communities were used, with one swab used for each towel. Cotton swabs were used to collect samples from the various eateries. Swabs were incubated at 37°C after being cultivated on nutrient agar, blood agar, chocolate agar, Saboraud dextrose agar (SDA), and Maconkey agar. Several biochemical assays were used, including the catalase, indole, oxidase, citrate, and coagulase tests. Macroscopic, microscopic, and differential techniques were used to identify microorganisms.

Sample Analysis/Methods

In the diagnostic laboratory of Saint Kenny Diagnostics and Research Consult, located in Ekpoma, Edo State, the sample was analyzed for bacteriological analysis.

Bacteriological Examination

Culture of Hand Towel Swab: On each plate of nutrient and blood agar, the swab stick was inoculated by creating a primary inoculum on a tiny portion of the plate and then streaking it out. The nutrient agar growth was subsequently subcultured into Maconkey and SDA agar. For twenty-four hours, the infected media was incubated aerobically at 37°C. Anaerobic incubation was used for those inoculated on chocolate agar. Biochemical tests were used to identify the bacterium [3].

Statistical Analysis

A statistical analysis was performed on the results. Each isolated microorganism's mean values were ascertained. To find out whether there were any notable differences between the products, analysis of variance was employed. The means of any significant difference were compared using the least significance (LSD) method [9].

RESULT

The assessment of the microbial load of bacterial species found in hand towels used in several restaurants in Ekpoma, Edo State, served as the basis for the study's findings. Fifty hand towel samples were gathered, ten from each of the five settlements in Ekpoma-Ihumudumu, Ujoelen, Idumebo, Ukhun, and Ujemen-of which 42 tested positive for microorganisms. 10 from Ihumudumu, 7 from Ujoelen, 8 from Idumebo, 8 from Ukhun, and 9 from Ujemen tested positive out of the 50 samples that were gathered from every community. Staphylococcus aureus, 3 yeast cells, 3 pennicillum, 21 Candida albicans, 2 E. coli, and 1 Klebsiella spp. were isolated from all 42 positive samples.

Table 1 displays the number and percentage of bacteria isolated from the hand towels of various restaurants from different communities in Ekpoma, with Ihumudumu community having the highest positive samples, followed by Ujemen society. The distribution of microorganisms isolated from each sample in the various communities in Ekpoma, with S. aureus being the most common bacterial isolate, is shown in Table 2, while Table 3 displays the percentage (%) and Mean±SD of each microorganisms isolated from the hand towels of various restaurants from the selected communities in Ekpoma.

These are illustrated in the tables below:

DISCUSSION

The study offers a microbiological assessment of the microorganisms found in hand towels used in a few restaurants in Ekpoma, Edo State. Based on the results, it was found that 84% of the isolated microorganisms from the hand towels of the various restaurants under study were positive, which is comparable to the findings of several earlier studies by Spiegel [9]. Of the 10 samples taken from each community, 10 (100%) tested positive for microorganisms in Ihumudumu, 7 (70%) tested positive for microorganisms in Ujoelen, 8 (80%) tested positive for microorganisms in Idumebo, 8 (80%) tested positive for microorganisms in Ukhun, 8 (80%) tested positive for microorganisms in Ujoelen, and 9 (90%) for microorganisms in Ujemen. Ujemen, Idumebo, Ukhun, and Ujoelen restaurants had the lowest bacterial load, whereas the samples from Ihumudumu restaurants seemed to have the highest number of microorganism isolates. Staphylococcus aureus, 3 yeast cells, 3 penicillium, 21 Candida albicans, 2 E. coli, and 1 Klebsiella spp. were isolated from all 42 positive samples. Additionally, it was demonstrated that, across all restaurants analyzed in Ekpoma, S. aureus had the highest number of bacteria isolated (39 total), followed by C. albicans (21 total), and Klebsiella spp. (one total). The mean±SD of all the bacteria that were isolated from the hand towels of the various restaurants from the various communities were as follows: 0.2±0.45 for Klebsiella spp., 4.2±2.17 for Candida albicans, 0.4±0.58 for E. coli, 1.±0.55 for yeast cells, and 1±0.55 for penicillium. The fact that most of the bacteria on the hand towels are Staphylococcus aureus indicates that the contamination is human. This does not mean that a disease hazard is likely, but it does raise the possibility. These organisms are native to humans and can be easily and readily recovered in large quantities from the body surfaces, even though they may be pathogenic [3]. There are a number of theories regarding the origin of these bacteria. Staph. aureus is a relatively common contaminant in and on many items in the environment, but they are somewhat linked to human contamination. Since this bacterium is typically found in the hand and skin, it can withstand heat, cold, and drying. Once more, the individual operating the dispenser might have handled the laundered towel incorrectly. Although their presence on towels alone does not imply the existence of a public health threat, these organisms indicate environmental contamination, such as dust, and they have the potential to be harmful. Williams notes, however, that despite thorough and thorough searches, a number of researchers were unable to detect these creatures in significant quantities on the skin of healthy individuals [10].

Not every single cloth towel in the sample, nevertheless, displayed signs of bacterial contamination. According to the investigation, the hand towels of the different eateries in Ekpoma that were assessed had comparatively high bacterial loads, with higher normal flora. This suggests that these eateries have inadequate hygiene practices, in addition to the growing usage of hand towels by people traveling to and from various work environments. According to the analysis, a large number of these eateries maintain their hand towels utilized in their establishments poorly, both in terms of cleaning and drying.

CONCLUSION

Paper towels are superior to hand cloth towels from a hygiene standpoint, so they should be recommended for use in places where hygiene is essential, like restaurants, hospitals, and clinics, and their proper disposal should be encouraged. The provision of paper towels should also be considered as a means of improving hand hygiene adherence among restaurant operators in Ekpoma. Hand hygiene has the potential to prevent diseases and reduce health care-associated infections. The proper drying of hands after washing should be an essential component of effective hand hygiene procedures. The majority of studies have found that paper towels can dry hands efficiently, remove bacteria effectively, and cause less environmental contamination. Our findings may have significance for health professionals and medical educators attempting to establish effective initiatives to enhance hand hygiene practices in eateries in Ekpoma. Therefore, it is advised that these restaurants employ serviette papers, also known as paper towels; wash hand dryers instead of hand towels; or, in the absence of air dryers or hand dryers, encourage the habit of rushing water.

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14. World Gazzetter (2007) Population of Cities, news, divisions.

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