title: Changes in hands microbiota associated with skin damage because of hand hygiene procedures on the health care workers.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Imunologia e Parasitologia Aplicadas, Programa de Pós Graduação em Imunologia e Parasitologia Aplicadas, Universidade Federal de Uberlândia, Minas Gerais, Brazil. lilianrocha23@yahoo.com.br
authors.forename: Lílian Alves
authors.initials: LA
authors.lastname: Rocha
authors.forename: Lizandra
authors.initials: L
authors.lastname: Ferreira de Almeida E Borges
authors.forename: Paulo Pinto
authors.initials: PP
authors.lastname: Gontijo Filho
mesh_terms: D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification*; D015169:Colony Count, Microbial; D017575:Gloves, Protective / Q000382:microbiology*; D006235:Hand Disinfection / Q000379:methods*; D006761:Hospitals; D006801:Humans; D009726:Nurses; D012867:Skin / Q000382:microbiology*; D012871:Skin Diseases / Q000382:microbiology*