Effect of Hand Cleansing with Antimicrobial Soap or Alcohol-Based Gel on Microbial Colonization of Artificial Fingernails Worn by Health Care Workers

Abstract

This study was undertaken to determine differences in microflora on the nails of health care workers (HCWs) wearing artificial nails compared with control HCWs with native nails and to assess the effect on these microflora of hand cleansing with antimicrobial soap or alcohol-based gel. Cultures were obtained from 21 HCWs wearing artificial nails and 20 control HCWs before and after using antimicrobial soap or alcohol-based gel. Before cleansing with soap, 86% of HCWs with artificial nails had a pathogen (gram-negative bacilli, Staphylococcus aureus, or yeasts) isolated, compared with 35% of controls (P=.003); a similar difference was noted before hand cleansing with gel (68% vs. 28%; P=.03). Significantly more HCWs with artificial nails than controls had pathogens remaining after hand cleansing with soap or gel. Of HCWs with artificial nails, only 11% cleared pathogens with soap compared with 38% with gel. Of control HCWs, only 14% cleared with soap compared with 80% with gel. Artificial acrylic fingernails could contribute to the transmission of pathogens, and their use by HCWs should be discouraged.

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

“…Ring wearing increased the frequency of hand contamination with potential health care-associated pathogens. Wearing artificial acrylic fingernails can also result in hands remaining contaminated with pathogens after use of either soap or alcohol-based hand gel 154 and has been associated with outbreaks of infection 155 (see also Part I, Section 23.4).…”

Avaliação da técnica de lavagem das mãos executada por alunos do Curso de Graduação em Enfermagem

“…The study about the use of antimicrobial soap or gel alcohol in hand hygiene concluded that there is frequently a substantial number of pathogens in subungual spaces, even after careful hand washing, with the use of surgical brushes (16) .…”