Beneath the mask: evaluating compliance with the guidelines for facemask use and bacteria contamination amongst healthcare workers with patient contacts at a Nigerian Tertiary Healthcare Facility

Healthcare workers (HCWs) are the first responders in healthcare facilities and are disproportionately exposed to infectious diseases. Facemask is a potential barrier to containing the spread of infectious droplets, aerosols and contaminated surfaces. This study isolated the bacterial contamination associated with using facemasks amongst HCWs interacting with patients. This research utilised the descriptive cross-sectional study design to obtain data from 161 HCWs selected through a multi-stage sampling technique. 2 mm × 2 mm of nose and mouth regions of facemasks were aseptically collected and cultured using standard methods. Antibiotic sensitivity tests were done using standard diagnostic kits. Most (61.5%) of HCWs were females, and 70.8% were between 20 and 39 years. 39.1%, 31.7%, 14.3% and 9.9% were nurses, doctors, health attendants and laboratory technicians, respectively. In this study, 62.7% and 49.7% had a good perception of WHO guidelines for using and removing facemasks, respectively. 74.5% of HCWs volunteered their used facemasks, and 25.6% had growth when cultured. The predominant bacteria isolates were Enterobacter agglomerans (62.5%), Proteus stuarti (28.1%) and Morganella morganii (9.4%) and 96.9% resistant to Augmentin and Ceftazidime, 93.8% were resistant to Cefuroxime and 87.5% were resistant to Cefixime with the highest zones of inhibition to Ofloxacin. Most HCWs have good knowledge but fail to practice the appropriate guidelines for facemask use. Facemasks harbour nosocomial organisms, and many of them are resistant to common antibiotics.