Bacterial carriage by artificial vereus natural nails

Survey of Knowledge, Beliefs, and Practices of Neonatal Intensive Care Unit Healthcare Workers Regarding Nosocomial Infections, Central Venous Catheter Care, and Hand Hygiene

“…4 Artificial fingernails and rings of healthcare workers have both been associated with higher bacterial colony counts on the hands. [5][6][7][8][9][10] In addition, bacterial colonization of the fingernails and hands of healthcare workers has been linked to the transmission of Pseudomonas aeruginosa, a common nosocomial pathogen among neonates. [11][12][13][14] Although evidence-based guidelines promoting handwashing and hand hygiene among healthcare workers are published and supported by several organizations, [15][16][17] there is considerable evidence that compliance with these measures is suboptimal.…”

Hand Hygiene

“…523 A growing body of evidence suggests that wearing artificial nails may contribute to the transmission of certain health care-associated pathogens. HCWs who wear artificial nails are more likely to harbour Gram-negative pathogens on their fingertips than those who have natural nails, both before and after handwashing 154,534,974,975 or handrub with an alcohol-based gel. 154 It is not clear if the length of natural or artificial nails is an important risk factor, since most bacterial growth occurs along the proximal 1 mm of the nail, adjacent to subungal skin.…”

“…154 It is not clear if the length of natural or artificial nails is an important risk factor, since most bacterial growth occurs along the proximal 1 mm of the nail, adjacent to subungal skin. 154,972,974 An outbreak of P. aeruginosa in a neonatal ICU was attributed to two nurses (one with long natural nails and one with long artificial nails) who carried the implicated strains of Pseudomonas spp. on their hands.…”

“…971,972 Even after careful handwashing or surgical scrubs, HCWs often harbour substantial numbers of potential pathogens in the subungual spaces. 154,973,974 In particular, the presence of fingernail disease may reduce the efficacy of hand hygiene and result in the transmission of pathogens. A cluster of P. aeruginosa SSIs resulted from colonization of a cardiac surgeon's onychomycotic nail.…”

“…962,965,966,968,1016 Artificial nails are prohibited (IB). 154,167,534,974,977 B. Sinks should be designed to reduce the risk of splashes (II). 235,552 C. If hands are visibly soiled, wash hands with plain soap before surgical hand preparation (II).…”