Association between universal gloving and healthcare-associated infections: A systematic literature review and meta-analysis

Chang, Nai-Chung; Kates, Ashley E.; Ward, Melissa; Kiscaden, Elizabeth; Reisinger, Heather Schacht; Perencevich, Eli N.; Schweizer, Marin L.

doi:10.1017/ice.2019.123

Cited by 10 publications

(7 citation statements)

References 21 publications

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Section: Universal Gloving and Contact Isolationsupporting

confidence: 78%

“…Similar conclusions can be drawn when looking to the most recent meta-analysis, showing how universal gloving may provide a small protective effect on healthcare-associated infections in pediatric/neonatal ICU patients (IRR 0.75; 95% CI, 0.65-0.87), but not in adult ICUs (IRR 1.01; 95% CI 0.91-1.13) [44]. However, this difference may also have been due to different care patterns or increased awareness among healthcare workers when dealing with the pediatric population, and it was not observed in the pooled analysis of RCTs only [44]. Moreover, another meta-analysis evaluating discontinuation of contact precautions for MDROs did not find increased infection rates by MRSA and VRE, with discordant results for ESBL and a trend toward an increase in C. difficile infections but with a very low rate of transmission [45].…”

Section: Universal Gloving and Contact Isolationsupporting

confidence: 78%

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Pathogenesis-Targeted Preventive Strategies for Multidrug Resistant Ventilator-Associated Pneumonia: A Narrative Review

et al. 2020

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Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection in the intensive care unit (ICU), accounting for relevant morbidity and mortality among critically ill patients, especially when caused by multidrug resistant (MDR) organisms. The rising problem of MDR etiologies, which has led to a reduction in treatment options, have increased clinician’s attention to the employment of effective prevention strategies. In this narrative review we summarized the evidence resulting from 27 original articles that were identified through a systematic database search of the last 15 years, focusing on several pathogenesis-targeted strategies which could help preventing MDR-VAP. Oral hygiene with Chlorhexidine (CHX), CHX body washing, selective oral decontamination (SOD) and/or digestive decontamination (SDD), multiple decontamination regimens, probiotics, subglottic secretions drainage (SSD), special cuff material and shape, silver-coated endotracheal tubes (ETTs), universal use of gloves and contact isolation, alcohol-based hand gel, vaporized hydrogen peroxide, and bundles of care have been addressed. The most convincing evidence came from interventions directly addressed against the key factors of MDR-VAP pathogenesis, especially when they are jointly implemented into bundles. Further research, however, is warranted to identify the most effective combination.

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Section: Universal Gloving and Contact Isolationsupporting

confidence: 78%

Section: Universal Gloving and Contact Isolationsupporting

confidence: 78%

Pathogenesis-Targeted Preventive Strategies for Multidrug Resistant Ventilator-Associated Pneumonia: A Narrative Review

et al. 2020

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“…Chang et al reported in a systematic review and metaanalysis of 8 studies that demonstrated that implemented universal gloving alone showed a signifi cant association with decreased incidence of hospital-acquired infections (IRR 0.77; 95% CI 0.67-0.89). 13 Our study also identifi ed a large cluster of 12 patients in a single location, which turned out to be the general medical ward, where there is maximum concentration of patients in the hospital with an open cubicle model, and sharing of a common centralised air system. This could have played a role in the transmission given the predominantly inhalation mode of transmission reported by Jones et al 13 Wong et al 14 reported early in the pandemic from Hong Kong that there was no transmission in a general ward in their hospital after extensive contact tracing and follow up of all the patients and hospital staff who had come into contact with an index case of COVID-19.…”

Section: Discussionmentioning

confidence: 85%

“…13 Our study also identifi ed a large cluster of 12 patients in a single location, which turned out to be the general medical ward, where there is maximum concentration of patients in the hospital with an open cubicle model, and sharing of a common centralised air system. This could have played a role in the transmission given the predominantly inhalation mode of transmission reported by Jones et al 13 Wong et al 14 reported early in the pandemic from Hong Kong that there was no transmission in a general ward in their hospital after extensive contact tracing and follow up of all the patients and hospital staff who had come into contact with an index case of COVID-19. However, that study concentrated on the transmission from a COVID-19 patient to other patients and to the staff members rather than from the staff member to the patients.…”

Section: Discussionmentioning

confidence: 85%

Analysis of An Outbreak of Nosocomial Covid-19 at a Tertiary Care Centre in South India

Rathish

Wilson

Warrier

et al. 2021

Journal of the Royal College of Physicians of Edinburgh

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IntroductionThe COVID-19 pandemic has caused nearly 46 million cases globally with nearly 1.2 million deaths. 1 It has been hypothesised that the principal mode of transmission of the causative SARS-CoV-2 virus involves exposure to respiratory droplets during close contacts with infected individuals. 2 However, SARS-CoV-2 is also thought to have airborne or aerosolised transmission under special circumstances, such as being in enclosed spaces, spaces having inadequate ventilation including the use of centralised air conditioning, and, of particular importance in healthcare facilities, aerosolgenerating procedures. 2,3 This characteristic of the virus coupled with a signifi cant proportion of asymptomatic carriers may contribute to its capability of transmission. 2 Hospitals and other healthcare facilities tend to have a combination of these factors present that can facilitate transmission of COVID-19 despite adequate infection control practices. There have been multiple reports of nosocomial transmission of COVID-19 even though the rates remain quite low. 4,5 The use of wards with multiple patients sharing a common air space, common air conditioning, common washrooms that may generate aerosols, as well as the potential of contact between hospital staff with patients during routine clinical care potentially increases the risk of nosocomial COVID-19. We report a cohort of 15 patients with possible nosocomial COVID-19 over a period of 48 days from a tertiary care centre in South India. We reviewed all the patients who were diagnosed to have COVID-19 3 days Background Nosocomial outbreaks of COVID-19 have been reported sporadically since the beginning of the COVID-19 pandemic. We sought to study the transmission dynamics in a nosocomial COVID-19 outbreak in our centre.Methods This was a retrospective cohort study in a 500 bedded tertiary care hospital in South India. Inpatients who were suspected to have likely or de nite hospitalacquired COVID-19 and hospital staff members who were found to be COVID-19 positive during the same time frame were studied and the likely transmission dynamics described.Results During the study period, 173 patients were diagnosed to have COVID-19, out of which, 15 (8.6%) patients who ful lled the criteria for likely or de nitely hospital-acquired COVID-19 infection were identi ed from six different wards. During the same period, 121 hospital staff members were diagnosed with COVID-19. Out of these, 18 (14.9%) hospital staff members were identi ed who could have been the potential source of infection for these 15 patients based on the overlap of location of the staff and the patients, and their infectivity windows. Direct contact and fomite transmission were likely the predominant driver of transmission in our study as there was use of universal face masks and face shields. ConclusionDespite the admission of a large number of COVID-19 patients and a relatively large proportion of hospital staff members who tested positive for the disease, the proportion of nosocomial COVID-19 in our centre ...

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“…Nonetheless, only a handful of small studies have evaluated the use of universal gloving as a method to reduce the incidence of HAI's. In a recent meta-analysis of studies that implemented universal gloving, Chang et al 7 showed a mixed impact on HAI depending on whether universal gloving was implemented alone or as part of intervention bundles.…”

mentioning

confidence: 99%

“If the glove fits”: Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection

Prasad

Brown

et al. 2021

Infect. Control Hosp. Epidemiol.

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Objective: To determine whether a hospital-wide universal gloving program resulted in increased hand hygiene compliance and reduced inpatient Clostridioides difficile infection (CDI) rates. Design: We carried out a multiple-year before-and-after quasi-experimental quality improvement study. Gloving and hand hygiene compliance data as well as hospital-acquired infection rates were prospectively collected from January 1, 2015, to December 31, 2017, by secret monitors. Settings: The University of Rochester Strong Memorial Hospital, an 849-bed quaternary-care teaching hospital. Patients: All adult inpatients with the exception of patients in the obstetrics unit. Interventions: A hospital-wide universal gloving protocol was initiated on January 1, 2016. Results: Hand hygiene compliance increased from 68% in 2015 reaching an average of 88% by 2017 (P < .0002). A 10% increase in gloving per unit was associated with a 1.13-fold increase in the odds of hand hygiene (95% credible interval, 1.12–1.14). The rates of CDI decreased from 1.05 infections per 1,000 patient days in 2015 to 0.74 in 2017 (P < .04). Conclusion: A universal gloving initiative was associated with a statistically significant increase in both gloving and hand hygiene compliance. CDI rates decreased during this intervention.

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Association between universal gloving and healthcare-associated infections: A systematic literature review and meta-analysis

Cited by 10 publications

References 21 publications

Pathogenesis-Targeted Preventive Strategies for Multidrug Resistant Ventilator-Associated Pneumonia: A Narrative Review

Pathogenesis-Targeted Preventive Strategies for Multidrug Resistant Ventilator-Associated Pneumonia: A Narrative Review

Analysis of An Outbreak of Nosocomial Covid-19 at a Tertiary Care Centre in South India

“If the glove fits”: Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection

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