{
  "abstract": "Background\n\nHealthcare workers' (HCWs) hands are primary vectors for pathogen transmission. While non-sterile examination gloves (NSG) are intended to protect against contamination, they are often perceived as a substitute for hand disinfection (HD). This crossover simulation study in student nurses compared the microbial kinetics of once-disinfected bare hands versus continued NSG use and explored unintended Staphylococcus aureus transmission between participants.Methods\n\nUsing a crossover design, twenty-five student nurses performed standardised nursing tasks on manikins under both conditions in randomised order: (i) NSG worn continuously for 45 min without change; (ii) HD with an alcohol-based hand rub immediately before tasks (no gloves). Hand-impression cultures were taken at 0, 5, 15, 25, 35 and 45 min, plate-reading after 24 and 48 h. Counts > 100 CFU were capped at 100. Behaviour was video monitored. Group differences were analysed using the Wilcoxon signed-rank test with Bonferroni correction; S. aureus detection (≥ 1 positive timepoint per arm) was compared by McNemar's exact test.Results\n\nIn the HD arm, mean CFU increased from 1.7 ± 3.3 (baseline) to 31.8 ± 30.4 at 5 min and then plateauing around 40-45 CFU for 15-45 min. In the NSG arm, CFU progressively accumulated, reaching 76.7 ± 29.1, 77.1 ± 27.7 and 81.0 ± 27.7 at 25, 35 and 45 min, respectively. From 25 min onwards, NSG counts were significantly higher than HD counts (p = 0.0007, 0.0012 and 0.0003; Bonferroni-corrected α = 0.0083). S. aureus (all methicillin-susceptible) was detected in at least one timepoint in 21/25 (84%) NSG-arm participants versus 9/25 (36%) HD-arm participants (McNemar p = 0.0005). Notably, one baseline nasal carrier, following an observed incomplete HD event, contaminated two co-workers via a shared manikin within 5 min, demonstrating HCW-to-HCW spread in the HD arm.Conclusions\n\nOnce-disinfected hands rapidly return to a stable resident microbiome level, whereas continued NSG use without glove changing leads to progressive microbial accumulation and substantially higher S. aureus carriage. NSG must not replace HD and require a change interval of 15-20 min, followed by HD after removal. HD must be performed correctly immediately before patient contact.",
  "abstract_shown": true,
  "affiliations": [
    "Dr. Gernot Walder-GmbH, Außervillgraten, East Tyrol, Austria.",
    "Institute for Primary Care Medicine, Johannes Kepler University (JKU), Linz, Austria.",
    "Y2L2Science GmbH, Zams, Austria.",
    "Dr. Gernot Walder-GmbH, Außervillgraten, East Tyrol, Austria. christian.bundschuh@tyrolpath.at.",
    "Institute for Primary Care Medicine, Johannes Kepler University (JKU), Linz, Austria. christian.bundschuh@tyrolpath.at.",
    "Laboratory Dr. Bundschuh, Oberstiftung 59, 4190, Bad Leonfelden, Austria. christian.bundschuh@tyrolpath.at."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "G Walder"
    },
    {
      "affs": [
        0
      ],
      "name": "R Pörnbacher"
    },
    {
      "affs": [
        2
      ],
      "name": "L Knabl"
    },
    {
      "affs": [
        0
      ],
      "name": "P Suntinger"
    },
    {
      "affs": [
        0
      ],
      "name": "S Obererlacher"
    },
    {
      "affs": [
        0
      ],
      "name": "K Edrisi Maryan"
    },
    {
      "affs": [
        0
      ],
      "name": "B Faustini"
    },
    {
      "affs": [
        3,
        4,
        5
      ],
      "name": "C Bundschuh",
      "orcid": "0009-0004-7289-088X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/30yhe1cxrts31.bib",
  "cited_by": 0,
  "doi": "10.1186/s13756-026-01801-z",
  "fulltext_url": "https://europepmc.org/articles/PMC13729465",
  "id": "30yhe1cxrts31",
  "issns": [
    "2047-2994"
  ],
  "landing_url": "https://europepmc.org/article/MED/42972601",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|Infection Control in Healthcare"
    ]
  ],
  "openalex": "W7172492120",
  "pdf_url": "https://europepmc.org/articles/PMC13729465?pdf=render",
  "pmcid": "PMC13729465",
  "pmid": "42972601",
  "published": "2026-08-05",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/30yhe1cxrts31.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:44Z",
      "native_id": "MED:42972601",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42972601"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Infection Control in Healthcare",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Hand hygiene versus continued glove use in simulated nursing care: a crossover study on microbial kinetics and unintended transmission.",
  "title_text": "Hand hygiene versus continued glove use in simulated nursing care: a crossover study on microbial kinetics and unintended transmission.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T03:20:56Z",
  "url": "https://research.draconitic.com/paper/30yhe1cxrts31",
  "venue": "Antimicrobial resistance and infection control",
  "versions": []
}