title: Antimicrobial resistance patterns of colonizing flora on nurses' hands in the neonatal intensive care unit.
abstract: 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.
  
  
  CONCLUSIONS
  Hand hygiene product and skin condition may influence resistance patterns of hand flora of care providers.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Cook
authors.forename: Jeannie P
authors.initials: JP
authors.lastname: Cimiotti
authors.forename: Phyllis
authors.initials: P
authors.lastname: Della-Latta
authors.forename: Lisa
authors.initials: L
authors.lastname: Saiman
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D002175:Candida / Q000187:drug effects; D018592:Cross-Over Studies; D024901:Drug Resistance, Multiple, Bacterial; D000431:Ethanol / Q000008:administration & dosage; D005932:Gloves, Surgical / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006095:Gram-Positive Cocci / Q000187:drug effects*; D006225:Hand / Q000382:microbiology*; D006235:Hand Disinfection; D006801:Humans; D007363:Intensive Care Units, Neonatal; D008826:Microbial Sensitivity Tests; D009726:Nurses
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol