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. 2022 Sep;36(9):1612-1622.
doi: 10.1111/jdv.18216. Epub 2022 May 18.

Effects of wearing personal protective equipment during COVID-19 pandemic on composition and diversity of skin bacteria and fungi of medical workers

X Lin  1 , Y Z Li  2 , T Chen  2 , S H Min  1 , D F Wang  1 , M M Ding  1 , G Jiang  1
Affiliations

Effects of wearing personal protective equipment during COVID-19 pandemic on composition and diversity of skin bacteria and fungi of medical workers

X Lin et al. J Eur Acad Dermatol Venereol. 2022 Sep.

Abstract

Background: During the COVID-19 pandemic, wearing PPE can induce skin damage such as erythema, pruritus, erosion, and ulceration among others. Although the skin microbiome is considered important for skin health, the change of the skin microbiome after wearing PPE remains unknown.

Objective: The present study aimed to characterize the diversity and structure of bacterial and fungal flora on skin surfaces of healthcare workers wearing personal protective equipment (PPE) during the COVID-19 pandemic using metagenomic next-generation sequencing (mNGS).

Methods: A total of 10 Chinese volunteers were recruited and the microbiome of their face, hand, and back were analysed before and after wearing PPE. Moreover, VISIA was used to analyse skin features.

Results: Results of alpha bacterial diversity showed that there was statistically significant decrease in alpha diversity indice in the skin samples from face, hand, and three sites after wearing PPE as compared with the indice in the skin samples before wearing PPE. Further, the results of evaluated alpha fungal diversity show that there was a statistically significant decrease in alpha diversity indices in the skin samples from hand after wearing PPE as compared with the indices in the skin samples before wearing PPE (P < 0.05). Results of the current study found that the main bacteria on the face, hand, and back skin samples before wearing the PPE were Propionibacterium spp. (34.04%), Corynebacterium spp. (13.12%), and Staphylococcus spp. (38.07%). The main bacteria found on the skin samples after wearing the PPE were Staphylococcus spp. (31.23%), Xanthomonas spp. (26.21%), and Cutibacterium spp. (42.59%). The fungal community composition was similar in three skin sites before and after wearing PPE.

Conclusion: It was evident that wearing PPE may affect the skin microbiota, especially bacteria. Therefore, it was evident that the symbiotic microbiota may reflect the skin health of medical workers during the COVID-19 pandemic.

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Figures

Figure 1
Figure 1
Rarefaction curve based on species diversity per sample.
Figure 2
Figure 2
Box plot of microbial Shannon index in B, A, BFa, AFa, BHa, AHa, BBa, and ABa group. (a) Box plot of the Shannon index for bacteria genus, (b) Box plot of the Shannon index for fungi genus. (NS P > 0.05 was considered not statistically significant, *P < 0.05 was considered statistically significant, and **P < 0.01 or ***P < 0.001 were considered extremely significant).
Figure 3
Figure 3
Box plot of microbial Simpson index in B, A, BFa, AFa, BHa, AHa, BBa, and ABa group. (a) Box plot of the Simpson index for bacteria genus, (b) Box plot of the Simpson index for fungi genus. (NS P > 0.05 was considered not statistically significant, *P < 0.05 was considered statistically significant, and **P < 0.01 or ***P < 0.001 were considered extremely significant).
Figure 4
Figure 4
Bacterial PCoA analysis before and after wearing PPE. (a) PCoA analysis in B and A group, (b) PCoA analysis in BFa and AFa group, (c) PCoA analysis in BHa and AHa group, (d) PCoA analysis in BBa and ABa group.
Figure 5
Figure 5
Fungal PCoA analysis before and after wearing PPE. (a) PCoA analysis in B and A group, (b) PCoA analysis in BFa and AFa group, (c) PCoA analysis in BHa and AHa group, (d) PCoA analysis in BBa and ABa group.
Figure 6
Figure 6
Relative abundance of bacteria and fungi classified at the genus level. (a) Bacteria classified at the genus level, (b) Fungi classified at the genus level.
Figure 7
Figure 7
Bacteria with relative abundance >1% in B and A group at the genus level.
Figure 8
Figure 8
Bacteria with relative abundance >1% in BFa, AFa, BHa, AHa, BBa, and ABa group at the genus level.
Figure 9
Figure 9
Fungi with relative abundance >1% in B and A group at the genus level.
Figure 10
Figure 10
Fungi with relative abundance >1% in BFa, AFa, BHa, AHa, BBa, and ABa group at the genus level.
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