Wearing Occlusive Gloves Increases the Density of Staphylococcus aureus in Patients with Hand Eczema
DOI:
https://doi.org/10.2340/00015555-3866Keywords:
hand eczema, Staphylococcus aureus, occlusive gloves, bacteria, alcohol-based hand rub, infection preventionAbstract
Hand eczema is frequently colonized with Staphylococcus aureus. Some patients with hand eczema wear occlusive gloves regularly; however, the effect of this on the density of S. aureus is unexplored. The aim of this study is to examine the effect of occlusive gloves on the density of S. aureus sampled from the hands of patients with hand eczema. In an experimental set-up, patients with moderate-to-severe hand eczema wore an occlusive glove on one hand for 4 h with a 30-min break. Bacterial swabs were collected from the most severe eczema lesion on the hand before and immediately after glove exposure. S. aureus colony-forming units were counted and log-transformations used for comparison of before- and after-values. Among 30 patients, 19 (63%) were colonized with S. aureus. After glove occlusion S. aureus colony-forming units increased by a factor of 1.72 (p < 0.01). In conclusion, the density of sampled S. aureus on eczematous skin after prolonged wearing of occlusive gloves is greatly increased.
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Quaade AS, Simonsen AB, Halling AS, Thyssen JP, Johansen JD. Prevalence, incidence and severity of hand eczema in the general population – a systematic review and meta-analysis. Contact Dermatitis 2021; 84: 361–374.
Haslund P, Bangsgaard N, Jarlov JO, Skov L, Skov R, Agner T. Staphylococcus aureus and hand eczema severity. Br J Dermatol 2009; 161: 772–777.
Mernelius S, Carlsson E, Henricson J, Lofgren S, Lindgren PE, Ehricht R, et al. Staphylococcus aureus colonization related to severity of hand eczema. Eur J Clin Microbiol Infect Dis 2016; 35: 1355–1361.
Nørreslet LB, Edslev SM, Andersen PS, Plum F, Holt J, Kjerulf A, et al. Colonisation with Staphylococcus aureus in patients with hand eczema: prevalence and association with severity, atopic dermatitis, subtype and nasal colonisation. Contact Dermatitis 2020; 83: 442–449.
Agner T, Elsner P. Hand eczema: epidemiology, prognosis and prevention. J Eur Acad Dermatol Venereol 2020; 34: 4–12.
Hamnerius N, Svedman C, Bergendorff O, Bjork J, Bruze M, Ponten A. Wet work exposure and hand eczema among healthcare workers: a cross-sectional study. Br J Dermatol 2018; 178: 452–461.
Lund T, Petersen SB, Flachs EM, Ebbehøj NE, Bonde JP, Agner T. Risk of work-related hand eczema in relation to wet work exposure. Scand J Work Environ Health 2020; 46: 437–445.
Lund T, Flachs EM, Sørensen JA, Ebbehøj NE, Bonde JP, Agner T. A job-exposure matrix addressing hand exposure to wet work. Int Arch Occup Environ Health 2019; 92: 959–966.
Ramsing DW, Agner T. Effect of glove occlusion on human skin (II). Long-term experimental exposure. Contact Dermatitis 1996; 34: 258–262.
Tiedemann D, Clausen ML, John SM, Angelova-Fischer I, Kezic S, Agner T. Effect of glove occlusion on the skin barrier. Contact Dermatitis 2016; 74: 2–10.
Eklund AM, Ojajärvi J, Laitinen K, Valtonen M, Werkkala KA. Glove punctures and postoperative skin flora of hands in cardiac surgery. Ann Thorac Surg 2002; 74: 149–153.
Wistrand C, Söderquist B, Falk-Brynhildsen K, Nilsson U. Exploring bacterial growth and recolonization after preoperative hand disinfection and surgery between operating room nurses and non-health care workers: a pilot study. BMC Infect Dis 2018; 18: 466–473.
Rotter ML, Kampf G, Suchomel M, Kundi M. Population kinetics of the skin flora on gloved hands following surgical hand disinfection with 3 propanol-based hand rubs: a prospective, randomized, double-blind trial. Infect Control Hosp Epidemiol 2007; 28: 346–350.
Kampf G, Meyer B, Goroncy-Bermes P. Comparison of two test methods for the determination of sufficient antimicrobial activity of three commonly used alcohol-based hand rubs for hygienic hand disinfection. J Hosp Infect 2003; 55: 220–225.
Kampf G, Ostermeyer C, Heeg P, Paulson D. Evaluation of two methods of determining the efficacies of two alcohol-based hand rubs for surgical hand antisepsis. Appl Environ Microbiol 2006; 72: 3856–3861.
Diepgen TL, Andersen KE, Chosidow O, Coenraads PJ, Elsner P, English J, et al. Guidelines for diagnosis, prevention and treatment of hand eczema. J Dtsch Dermatol Ges 2015; 13: e1–22.
Held E, Skoet R, Johansen JD, Agner T. The hand eczema severity index (HECSI): a scoring system for clinical assessment of hand eczema. A study of inter- and intraobserver reliability. Br J Dermatol 2005; 152: 302–307.
Oosterhaven JAF, Schuttelaar MLA. Responsiveness and interpretability of the Hand Eczema Severity Index. Br J Dermatol 2020; 182: 932–939.
Agner T, Aalto-Korte K, Andersen KE, Foti C, Gimenez-Arnau A, Goncalo M, et al. Classification of hand eczema. J Eur Acad Dermatol Venereol 2015; 29: 2417–2422.
Stenberg B, Lindberg M, Meding B, Svensson A. Is the question ‘Have you had childhood eczema?’ useful for assessing childhood atopic eczema in adult population surveys? Contact Dermatitis 2006; 54: 334–337.
Domingue G, Costerton JW, Brown MR. Bacterial doubling time modulates the effects of opsonisation and available iron upon interactions between Staphylococcus aureus and human neutrophils. FEMS Immunol Med Microbiol 1996; 16: 223–228.
Gammon J, Hunt J. COVID-19 and hand hygiene: the vital importance of hand drying. Br J Nurs 2020; 29: 1003–1006.
Belay N, Rasooly A. Staphylococcus aureus growth and enterotoxin A production in an anaerobic environment. J Food Protection 2002; 65: 199–204.
Szafrańska AK, Junker V, Steglich M, Nübel U. Rapid cell division of Staphylococcus aureus during colonization of the human nose. BMC Genomics 2019; 20: 229–241.
Lambers H, Piessens S, Bloem A, Pronk H, Finkel P. Natural skin surface pH is on average below 5, which is beneficial for its resident flora. Int J Cosmet Sci 2006; 28: 359–370.
Aly R, Shirley C, Cunico B, Maibach HI. Effect of prolonged occlusion on the microbial flora, pH, carbon dioxide and transepidermal water loss on human skin. J Invest Dermatol 1978; 71: 378–381.
Costerton JW, Geesey GG, Cheng KJ. How bacteria stick. Sci Am 1978; 238: 86–95.
Hepburn L, Hijnen DJ, Sellman BR, Mustelin T, Sleeman MA, May RD, et al. The complex biology and contribution of Staphylococcus aureus in atopic dermatitis, current and future therapies. Br J Dermatol 2017; 177: 63–71.
Ibler KS, Jemec GB, Flyvholm MA, Diepgen TL, Jensen A, Agner T. Hand eczema: prevalence and risk factors of hand eczema in a population of 2274 healthcare workers. Contact Dermatitis 2012; 67: 200–207.
Tauber M, Berard E, Lourari S, Questel E, Redoules D, Paul C, et al. Latent class analysis categorizes chronic hand eczema patients according to skin barrier impairment. J Eur Acad Dermatol Venereol 2020; 34: 1529–1535.
Wang X, Xu W, Chen Y, Zhang C, Chen L, Lu Y, et al. Staphylococcus aureus colonization and chronic hand eczema: a multicenter clinical trial. Arch Dermatol Res 2019; 311: 513–518.
Statens Serum Institut, Central Enhed for Infektionshygiejne 2.1 udgave 2021, Nationale Infektionshygiejniske Retningslinjer [cited 2021 May], Available from: https://hygiejne.ssi.dk/NIRhaandhygiejne.
World Health Organization (WHO). Glove use information leaflet 2009 [cited May 2020]. Available from: https://www.who.int/gpsc/5may/Glove_Use_Information_Leaflet.pdf.
World Health Organization. Best Practices for Injections and Related Procedures Toolkit. Annex A, Indications for glove use in health care. 2010. [cited 2021 May]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK138494/.
Harnoss JC, Partecke LI, Heidecke CD, Hübner NO, Kramer A, Assadian O. Concentration of bacteria passing through puncture holes in surgical gloves. Am J Infect Control 2010; 38: 154–158.
World Health Organization (WHO). Hand hygiene, why, how and when 2009 [cited May 2020] Available from: https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf.
Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC, et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol 2010; 31: 283–294.
Gold NA, Mirza TM, Avva U. Alcohol sanitizer. StatPearls. Treasure Island, FL: StatPearls Publishing, ©2020, StatPearls Publishing LLC.; 2020.
Widmer AE, Dangel M. Alcohol-based handrub: evaluation of technique and microbiological efficacy with international infection control professionals. Infect Control Hosp Epidemiol 2004; 25: 207–209.
Fagernes M, Lingaas E. Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers. J Adv Nurs 2011; 67: 297–307.
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