Effect of hand cleansing with antimicrobial soap or alcohol-based gel on microbial colonization of artificial fingernails worn by health care workers

This study was undertaken to determine differences in microflora on the nai ls of health care workers (HCWs) wearing artificial nails compared with con trol HCWs with native nails and to assess the effect on these microflora of hand cleansing with antimicrobial soap or alcohol-based gel. Cultures were obtained from 21 HCWs wearing artificial nails and 20 control HCWs before and after using antimicrobial soap or alcohol-based gel. Before cleansing w ith soap, 86% of HCWs with artificial nails had a pathogen (gram-negative b acilli, Staphylococcus aureus, or yeasts) isolated, compared with 35% of co ntrols (P = .003); a similar difference was noted before hand cleansing wit h gel (68% vs. 28%; P = .03). Significantly more HCWs with artificial nails than controls had pathogens remaining after hand cleansing with soap or ge l. Of HCWs with artificial nails, only 11% cleared pathogens with soap comp ared with 38% with gel. Of control HCWs, only 14% cleared with soap compare d with 80% with gel. Artificial acrylic fingernails could contribute to the transmission of pathogens, and their use by HCWs should be discouraged.