Changes in hands microbiota associated with skin damage because of hand hygiene procedures on the health care workers

Am J Infect Control. 2009 Mar;37(2):155-9. doi: 10.1016/j.ajic.2008.04.251.


Background: The purpose of this study was evaluating the microbial flora of nurses' healthy (n = 30) and damaged hand (n = 30) by frequent handwashing and/or wearing of gloves.

Methods: Hand cultures were obtained both before and after washing hands with nonantimicrobial soap, through the sterile polyethylene bag method.

Results: The bacteria counts of the hands of professionals with damaged hands were higher than those with healthy hands, and those with damaged hands presented higher frequency of Staphylococcus aureus, 16.7% versus 10%; gram-negative bacteria, 20% versus 6.7%; and yeast, 26.7% versus 20%, respectively, as well as the sum of these microorganisms. The presence of Staphylococcus haemolyticus was only seen in nurses with damaged hands (P = .02), and enterococci were not recovered from the hands of any volunteer. The presence of antimicrobial-resistant S aureus and gram-negative bacteria was also greater among damaged hands.

Conclusion: The irritation caused on the skin by frequent washing and/or wearing of gloves is associated with changes in hands microbial flora, and their potential risks should be considered when institutions/users are selecting products/formulations to assure hands skin health and consequent compliance with their own hygiene procedures.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteria / classification*
  • Bacteria / isolation & purification*
  • Colony Count, Microbial
  • Gloves, Protective / microbiology*
  • Hand Disinfection / methods*
  • Hospitals
  • Humans
  • Nurses
  • Skin / microbiology*
  • Skin Diseases / microbiology*