Hand carriage of aerobic gram-negative rods may not be transient

Abstract

In order to determine whether hand carriage of aerobic Gram-negative rods is continuous we used the glove-handwash technique to sample the hands of two groups (four each) of health care workers with normal hands (surgical intensive care unit, medical ward) and one group (four) with hand dermatitis (HD) and a group (five) of control subjects -- secretaries with no exposure to patients. Each subject was sampled repeatedly over three to six weeks. The mean number of samples for each group was 25.2, 23.2, 19.8 and 25.8 respectively. The HD group had more samples positive for aerobic Gram-negative rods than did the other two groups of health care workers while the control group had more samples positive than any of the three health care groups. Using various typing schemes and the following definition of continuous carriage (the isolation of an organism of the same serotype, pyocin type or biotype from more than two handwash samples) we found that 4 of 11 subjects from whom Klebsiella pneumoniae was isolated carried this organism continuously; 2 of 3 carried Pseudomonas aeruginosa continuously and 4 of 5 of the control subjects carried the same biotype of Enterobacter agglomerans continuously. We conclude that continuous hand carriage of aeroic Gram-negative rods is common and, among health care workers, those with hand dermatitis carry Gram-negative rods more frequently and in greater numbers than health care workers without hand dermatitis.