Removal of Nosocomial Pathogens from the Contaminated Glove

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Abstract
The effectiveness of three different types of handcleansing agents in decontaminating gloved hands that were inoculated with a series of four nosocomial pathogens was evaluated. Five healthy volunteers participated in all portions of the study. A standard concentration of one of four representative nosocomial pathogens was placed on the gloved hand, spread, and allowed to dry. One of three different handcleansing agents.sbd.a nonmedicated soap, a 60% isopropyl alcohol preparation, or 4% chlorhexidine gluconate.sbd.was used to cleanse the gloves, which were cultured using a broth-bag technique. The gloves were then removed and the hands were cultured in a similar manner. The handwashing agents reduced the median log10 counts of organisms to 2.1 to 3.9 after an inoculation of 107 colony forming units. The proportion of positive glove cultures for Staphylococcus aureus, 8% to 100%; Serratia marcescens, 165 to 100%; and Candida albicans, 4% to 60% varied greatly after use of the different handcleansers (P < 0.001), and varied considerably for Pseudomonas aeruginosa, 20% to 48% (P = 0.085). After the gloves were removed, the differences among the observed proportions of hands contaminated with the test organisms varied from 5% to 50%, depending on the hand-cleansing agent used (P < 0.001). In the era of universal precautions these data suggest tht it may not be prudent to wash and reuse gloves between patients. Further, handwashing is strongly encouraged after removal of gloves.