title: Emergence of resistant staphylococci on the hands of new graduate nurses.
abstract: OBJECTIVE
  To describe the aerobic microbial flora on the hands of experienced and new graduate nurses over time.
  
  
  METHODS
  A prospective cohort design that examined the relationship between duration of employment in an intensive care unit (ICU) and the microbial flora on the hands of experienced and new graduate nurses during a 23-month period.
  
  
  METHODS
  A 50-bed, level III-IV neonatal ICU in New York City.
  
  
  METHODS
  Twelve experienced nurses and 9 new graduate nurses working full time in the NICU.
  
  
  METHODS
  One hundred fifty samples were obtained from the clean, dominant hands of the nurses. Cultures were performed at baseline and then quarterly for each experienced and new graduate nurse. Baseline and final cultures of Staphylococcus epidermidis were further examined using pulsed-field gel electrophoresis.
  
  
  RESULTS
  At baseline, a significantly larger proportion of the experienced nurses had methicillin-resistant, coagulase-negative staphylococci isolated from their hands compared with the new graduate nurses (95% and 33%, respectively; P = .0004). For a second culture, performed 1 to 4 months later, there were no longer significant differences between the two groups (82% and 54%, respectively; P = .12). By the last culture, all staphylococcal isolates were methicillin resistant in both groups of nurses; 3 were methicillin-resistant S. aureus.
  
  
  CONCLUSIONS
  Colonization with methicillin-resistant staphylococci occurred after brief exposure to the hospital environment, despite the use of antiseptic hand hygiene agents. Furthermore, at final culture, the two groups shared one dominant hospital-acquired strain of S. epidermidis.
authors.affiliation: Columbia University School of Nursing, New York, New York, USA.
authors.forename: Jeannie P
authors.initials: JP
authors.lastname: Cimiotti
authors.forename: Fann
authors.initials: F
authors.lastname: Wu
authors.forename: Phyllis
authors.initials: P
authors.lastname: Della-Latta
authors.forename: Mirjana
authors.initials: M
authors.lastname: Nesin
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
mesh_terms: D015331:Cohort Studies; D004511:Education, Nursing, Graduate; D016521:Electrophoresis, Gel, Pulsed-Field; D007363:Intensive Care Units, Neonatal; D016106:Methicillin Resistance; D009519:New York City; D009741:Nursing Staff, Hospital; D013045:Species Specificity; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification*; D000078329:Workforce