Long Nails Linked to Deaths in NICUs

Feb. 12, 2024
Several studies have drawn correlations between long or artificial fingernails and transmission of bacteria in NICUs

A recent article about a NICU baby who passed away due to bacteria from a nurse’s long nails has renewed interest in past studies correlating long nails and NICU infections and deaths.

Health experts say that “artificial or natural nails that extend more than ¼ inch beyond the fingertip can harbor more bacteria and pathogens than short nails. The additional surface area and spaces under longer nails create an ideal environment for the growth of dangerous microbes like methicillin-resistant Staphylococcus aureus (MRSA) and other staph bacteria.” Improperly washed hands are often the culprit in spreading these bacteria from nurse to patient.

A past article from KevinMD “discusses a case where a NICU baby contracted E.Coli and passed away. The infection was linked to a nurse’s long nails.” Another study published in the journal Infection Control and Hospital Epidemiology “found a possible connection between long or artificial fingernails on nurses and an outbreak of Psuedomonas aeruginosa in a [NICU] that lasted 5 months.” That outbreak did not cause any deaths, but research showed that nurses with “long or artificial nails were more likely to test positive for P. aeruginosa, especially under the nails.” In addition, “when nurses trimmed or removed their long nails, the number of new Psuedomonas cases dropped.” The study ultimately concluded that “long or artificial fingernails on medical staff may make it more difficult to properly clean hands and nails,” which heightens the risk of infection among patients.

Another study, studying data from 1997 and 1998 in an Oklahoma City hospital, found that 16 infant deaths were linked to “pathogens found under the long fingernails of two nurses.” However, the state epidemiologist who was involved in crafting the report emphasized that “there was no definitive means to ascertain this as the transmission mechanism.”

Proper hand hygiene is essential in mitigating the risk of infection. CDC recommends that, in addition to proper hygiene practices, that all staff have short natural nails. Many hospitals require “nursing staff to keep nails trimmed to ¼ inch or less beyond the fingertip.”

The article can be found on nurse.org.