Fingernail Bacteria Linked to Baby Deaths in Hospital
March 23, 2000 (Atlanta) -- A potentially lethal bacteria found under the fingernails of some nurses at the Children's Hospital of Oklahoma may be linked to the deaths of 16 babies there, according to a new study.
But Michael Crutcher, MD, MPH, cautions, "To look at this in a vacuum and say that they had 16 deaths over this period of months can be misleading." Crutcher is a co-author of the study and Oklahoma state epidemiologist.
The CDC, the state health department, and the hospital conducted the study, prompted by the deaths of the 16 babies in intensive care during 1997 and the first three months of 1998. During that time, 439 babies were assigned to the hospital's neonatal intensive care unit. About 10%, or 46, of the babies were infected with a bacteria called Pseudomonas aeruginosa and developed a bloodstream infection. Of that number, 35%, or 16, of the babies died.
"Over a period of months, the [death] rate was going up just slightly in our neonatal intensive care unit," Gay Conner, hospital spokesperson, tells WebMD. "Normally, it's about 15% to 20% per month, and it was going up by maybe one baby per month. ... You think, OK, we probably need to look at this and see if there's anything that's causing that trend to go up. So we immediately called the Centers for Disease Control, got them to come out and instigate a study, which they did."
Crutcher says there was "certainly a blip on the screen; the rate went up." But, he tells WebMD, "this is a very high-risk setting. Deaths are routine in this population; they have a significant death rate, and a very high risk of infections in this setting. These are premature children [who] have complicated medical problems. ... It's not as if this was something that was some unusual strange disease that was brought in and was transmitted around among a bunch of kids without problems."
The CDC took hand cultures from 104 health care workers within that environment, and that particular strain of bacteria was isolated from three nurses. One had long, natural fingernails, a second had long, fake nails, and the third had short, natural nails.
The researchers found an association with the infection and its exposure to the first two nurses, who had the long fingernails. The third nurse with the short nails was ruled out as a possible source of exposure.
The researchers wrote, "Genetic and environmental evidence supported that association, and suggested, but did not prove, a possible role for long or artificial fingernails in the colonization of healthcare workers' hands with P. aeruginosa."
"There's no way that we can prove definitely that that is the cause right now, but that [long fingernails] did seem to increase the risk of infection," says Crutcher.