Healthcare Workers’ Hand Microbiome May Mediate Carriage of Hospital Pathogens

Mariana Rosenthal¹, Allison Aiello¹, Elaine Larson², Carol Chenoweth¹ and Betsy Foxman^1,*

¹ Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA² School of Nursing and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA

* Author to whom correspondence should be addressed.

Received: 11 October 2013; in revised form: 26 November 2013 / Accepted: 19 December 2013 / Published: 27 December 2013

(This article belongs to the Special Issue Gut Microbiome)

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Abstract: One function of skin microbiota is to resist colonization and infection by external microorganisms. We sought to detect whether the structure of the hand microbiota of 34 healthcare workers (HCW) in a surgical intensive care unit mediates or modifies the relationship between demographic and behavioral factors and potential pathogen carriage on hands after accounting for pathogen exposure. We used a taxonomic screen (16S rRNA) to characterize the bacterial community, and qPCR to detect presence of Staphylococcus aureus, Enterococcus spp., methicillin-resistant Staphylococcus aureus (MRSA), and Candida albicans on their dominant hands. Hands were sampled weekly over a 3-week period. Age, hand hygiene, and work shift were significantly associated with potential pathogen carriage and the associations were pathogen dependent. Additionally, the overall hand microbiota structure was associated with the carriage of potential pathogens. Hand microbiota community structure may act as a biomarker of pathogen carriage, and modifying that structure may potentially limit pathogen carriage among HCW.

Keywords: skin; hand; microbiome; microbiota; hand hygiene; healthcare; pathogen