You should never, ever skip washing your hands after you go. 

By Samantha Lauriello
October 24, 2019

If you do anything at all—even just one tiny thing—for your own health and the health of others, please just wash your hands after you poop.

That plea comes from a new study, in which researchers found that not washing your hands after you go number two is more likely to spread drug-resistant E. coli than consuming raw or under-cooked meat. (Though, it should be said that this study only focused on one specific strain of E. coli—there are still other types of E. coli, and other bacteria in general, that can come from eating under-cooked meat.)

The study, published Tuesday in The Lancet Infectious Diseases, aimed to determine whether Extended-spectrum β-lactamase-producing Escherichia coli (aka, ESBL-E. coli or drug-resistant E. coli) that cause bloodstream infections were mainly picked up from animal products or passed from person to person—something that, until now, was unknown. The specific type of E. coli lives in the intestines of humans and animals and is mostly harmless, but some strains can cause food poisoning symptoms like diarrhea and vomiting, urinary tract infections, and even blood infections.

For the study, researchers from the National Infection Service, Animal and Plant Health Agency, and other public health agencies and universities across the UK tested samples of the drug-resistant E. coli from beef, pork, and chicken and compared the results to samples from human feces, sewerage, and blood.

They found the strains that came from the human samples were similar to one another, but they were different from those found in animals. That means there's little crossover of ESBL-E. coli from animals to humans and that it's spread primarily between humans. "The great majority of strains of ESBL-E. coli causing human infections aren't coming from eating chicken, or anything else in the food chain," lead study author David Livermore, a professor at University of East Anglia's Norwich Medical School said in a press release.

RELATED: Everything You Need to Know About E. Coli Symptoms—in Case There's Another Outbreak

As for exactly how ESBL-E. coli is spread from human to human, Livermore said it takes an incredibly unpleasant fecal–oral route. "Rather—and unpalatably—the likeliest route of transmission for ESBL-E. coli is directly from human to human, with [fecal] particles from one person reaching the mouth of another," he said.

The infections caused by ESBL-E. coli bacteria are a huge problem in the UK right now, with over 40,000 cases of blood poisoning from E. coli each year in England alone—10% of which are from the drug-resistant ESBL-E. coli. 

"Infections caused by ESBL-E. coli bacteria are difficult to treat," Livermore said in the press release. "And they are becoming more common in both the community and hospitals. Mortality rates among people infected with these superbug strains are double those of people infected with strains that [are] susceptible to treatment."

Luckily, there's a relatively easy fix: hand washing. While Livermore didn't tell people to throw their food prep safety skills down the drain, he said that proper hand washing is paramount to stopping the spread of ESBL-E. coli. "We need to carry on cooking chicken well and never to alternately handle raw meat and salad," he said. "But here—in the case of ESBL-E. coliit's much more important to wash your hands after going to the toilet." That's especially true, he said, since ESBL-E. coli infections run rampant in elderly care homes. 

As for proper hand–washing techniques: Always do it after going to the bathroom, handling diapers, touching animals, handling food, before feeding your children, and any other time your see fit. Soap and water is always best (for at least 20 seconds, per the CDC), but an alcohol-based sanitizer (at least 60% alcohol) will do if you're stuck without a sink. 

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