Antimicriobial resistance patterns of colonizing flora on nursesʹ hands in the neonatal intensive care unit

Background The Centers for Disease Control and Prevention recommends the use of an alcohol-based handrub for health care worker hand hygiene. The purpose of this study was to examine effects of hand hygiene product and skin condition on the antimicrobial resistance patterns of colonizing hand flora among nurses. Methods Colonizing hand flora of 119 nurses working in 2 neonatal intensive care units was compared during a 22-month crossover study using alcohol handrub or antiseptic soap. Results Altogether, 1442 isolates from 834 hand cultures (mean, 7 cultures/nurse) were obtained. In 3 of 9 regression analyses modeling for resistant staphylococcal flora, the use of antiseptic soap was a significant predictor of resistance, and nurses with damaged skin were 2.79 times more likely to carry Staphylococcus warneri isolates resistant to gentamicin. Conclusion Hand hygiene product and skin condition may influence resistance patterns of hand flora of care providers.