title: A prospective comparative study of the relationship between different types of ring and microbial hand colonization among pediatric intensive care unit nurses.
abstract: OBJECTIVE
  The aim of the study is to assess the effect of ring wearing and ring types on hand contamination and efficacy of alcohol-based hand disinfection among nurses working in intensive care settings.
  
  
  METHODS
  Hand cultures were obtained from 84 nurses providing direct patient care in intensive care units of a pediatric hospital. Colony counts were compared depending on ring wearing and the type of ring worn. Twenty-eight nurses were asked to a wear plain wedding ring, 28 to wear rings with stones and 28 not to wear any rings, starting 15 days before and continuing throughout the study. Cultures were obtained by using sterile gloves containing phosphate-buffered-saline solution (PBS) after an alcohol-based hand disinfectant was used and bacteria were identified with standard laboratory tests.
  
  
  RESULTS
  The nurses wearing rings had more Gram-positive, Gram-negative and total bacterial colonization on their hands than the nurses without rings despite using an alcohol-based rub (p=0.001). When comparing the two groups with rings (plain wedding rings and rings with stones), colony counts of Gram-positive, Gram-negative and total bacteria did not differ (p>0.05).
  
  
  CONCLUSIONS
  Ring wearing increases the bacterial colonization of hands and alcohol-based hand disinfection might not significantly reduce contamination of the ring-wearing hands. The type of ring did not cause any significant difference on the bacterial load. Wearing rings could increase the frequency of transmission of potential nosocomial pathogens.
authors.affiliation: Hacettepe University Ihsan Dogramaci Children Hospital, Infection Control Unit, Sihhiye 06100, Ankara, Turkey. inciy@hacettepe.edu.tr
authors.forename: Inci
authors.initials: I
authors.lastname: Yildirim
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ceyhan
authors.forename: Ali Bulent
authors.initials: AB
authors.lastname: Cengiz
authors.forename: Arzu
authors.initials: A
authors.lastname: Bagdat
authors.forename: Cagri
authors.initials: C
authors.lastname: Barin
authors.forename: Tezer
authors.initials: T
authors.lastname: Kutluk
authors.forename: Deniz
authors.initials: D
authors.lastname: Gur
mesh_terms: D000433:1-Propanol / Q000008:administration & dosage* / Q000494:pharmacology; D015400:Clinical Nursing Research; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control / Q000635:transmission; D004203:Disinfection / Q000379:methods; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D006225:Hand / Q000382:microbiology*; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control / Q000706:statistics & numerical data; D015278:Intensive Care Units, Pediatric; D055498:Jewelry / Q000145:classification / Q000382:microbiology*; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D000433:1-Propanol