The aim of this review is to show the historical aspects of hands washing for healthy life and explains how can reduce the transmission of community-acquired infectious agents by healthcare workers and patients. This review article is prepared based on available database. The key words used were hands washing, risk assessment, hands hygiene, bacterial flora, contamination, infection, nosocomial, tap water, sanitizer, bacterial resistance, hands bacterial flora, washing methods, antiseptics, healthcare workers, healthcare personnel, from PubMed, ScienceDirect, Embase, Scopus, Web of Sciences, and Google Scholar. Data were descriptively analyzed. The insistence on hand washing has a history of 1400 years. The research results indicate that the bacteria released from the female washed hands in wet and dry condition was lower than from the male's hands with a significance level (3 CFU vs. 8 CFU; confidence interval 95%, P ≤ 0.001). The valuable results of the study indicated that released amount of bacterial flora from wet hands is more than 10 times in compared to dry hands. In addition, established monitoring systems for washing hands before and after patient's manipulation as well as after toilet were dominant indices to prevent the transfer of infectious agents to the patients. Increasing awareness and belief of the healthcare workers have shown an important role by about 30% reduction in the transfection. Hand washing could reduce the episodes of transmission of infectious agents in both community and healthcare settings. However, hand washing is an important key factor to prevent transmission of infectious agents to patients. There is no standard method for measuring compliance. Thus, permanent monitoring of hand washing to reduce the transmission of infections is crucial. Finally, the personnel must believe that hand washing is an inevitable approach to infection control.

Background: In recent years, the roles of Staphylococcal enterotoxins in the non-gastrointestinal diseases have been reported. The most frequently mentioned was enterotoxin type A. But in many cases there are also high similarity with type P. Accordingly, the differentiation of producing enterotoxin type P strains from type A is essential.Objectives: The objective of this study was to assess and characterize Staphylococcus aureus containing entP gene from infectious specimens.Materials and Methods: Based on the reference sequence (S. aureus N315 entP gene), pair primers were designed. 350 clinical strains of S. aureus were assessed by polymerase chain reaction (PCR). The purified PCR product was sequenced. All isolated S. aureus strains containing the entP gene were tested by Enzyme immunoassay.Results: The PCR amplification method was optimized for entP gene detection. The used primer pairs were amplified for 213 bp and 700 bp fragment separately. The sequencing results indicate that only 98 (28%) out of the 350 strains of S. aureus contained entP gene. The results of Enzyme immunoassay test for enterotoxins detection revealed that 79 (22.57%) of the strains contained entP gene were which also produced other enterotoxins (such as enterotoxin A to E) and 19 (5.43%) of the strains were carriers of only enterotoxin P gene unable to produce other enterotoxins.Conclusions: The results revealed, the specific primers that amplified the entE gene were able to amplify the Staphylococcal Enterotoxin-Like Toxin Type P gene. The specific primers for the entP gene were amplified a fragmented gene (700 bp) showed 100% homology with entP reference gene and also 80% homology with entA and entE genes

Background:In the previous studies using the commercial ELISA kit, the existence of staphylococcal superantigens has been reported in synovial fluid of patients with rheumatoid arthritis (RA).Objectives:This study aimed to design molecular methods to detect staphylococcal enterotoxin C in synovial fluid of patients with rheumatoid arthritis.Materials and Methods:In this experimental study, Staphylococcus aureus strain producing enterotoxin C was used as the reference strain. The polymerase chain reaction (PCR) was set up by design a specific pair of primers. Besides bacterial culture, 50 synovial fluid samples of patients with rheumatoid arthritis were subjected to DNA extraction, and then PCR amplification was carried out according to the protocol. All samples were examined by ELISA method for enterotoxin C. The data were descriptively analyzed.Results:The results of bacterial culture were negative for all samples. The results showed that 66% (33 cases) of samples contained entC gene and only 46% (23 cases) have also enterotoxin C. The interesting finding was that the results of ELISA and PCR were the same and have shown only 22 positive cases (44%samples) for staphylococcal enterotoxin C.Conclusions:Based on the findings of this study, S. aureus enterotoxin C (SEC) has been detected in synovial fluid of patients with rheumatoid arthritis by PCR and ELISA methods. These valuable findings may describe the exact etiology of the RA and as well as change the methods of its diagnosis and treatment. This is the first research, which has shown the staphylococcal entC gene in synovial fluid of RA patients. However, S. aureus strains can produce more than 20 types of enterotoxins. Therefore, its involvement on rheumatoid arthritis pathogenesis makes an important challenge in the future. In this regard, further investigation on the other enterotoxins is necessary.