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B. Mason, D. Goldman, D. Miller, W. Lee; Finding INfectious Growths on the Extremities of Residents (f.i.n.g.e.r. Study) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1893.
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This study sought to evaulate 1) the epidemiology of bacterial flora of ophthalmic healthcare providers' fingers during patient exams, 2) whether different healthcare providers (ie. residents vs. attendings) have greater bacterial colonization, and 3) which cleansing agent is more efficient at removing these organisms.
Five residents, fellows, and attendings were encountered during patient examinations and were asked to touch the pad of their pointer finger to the center of a chocolate agar plate. By coin flip, they were randomized to then wash with either CV medicated soap or Cal Stat, then touch a second chocolate agar plate. Participants were asked to wash their hands as they would in a normal patient encounter. These chocolate agar plates were then brought to the microbiology laboratory where they were cultured and evaluated at 48 hours and 7 days by traditional criteria.
For residents 4/5 grew 1–2+ coagulase negative staphylococcus and 2/5 1+ Bacillus (not anthracis). 1/(3 treated with cal stat) had trace staphylococcus and 1/(2 treated with soap) had 1+ staphylococcus. For fellows 4/5 grew trace 1+ coagulase negative staphylococcus. 1/(1 treated with cal stat) had no growth and 2/(4 treated with soap) had trace staphylococcus growth. For attendings 5/5 grew 1–2+ coagulase negative staphylococcus. 3/(3 treated with cal stat) had no growth and 2/(2 treated with soap) had 1–2+ staph growth.
The fingers of healthcare workers in ophthalmology are frequently colonized with bacteria. While the organisms cultured from fingers of ophthalmic healthcare providers are less harmful than those of ICU workers from a systemic standpoint, they comprise the most frequent agents associated with endophthalmitis. Cal Stat is superior to CV medicated hand lotion in reducing bacterial counts, however the results may be due to contamination with the paper towel for drying.
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