OBJECTIVES
To quantify the multidrugâresistant organism (MDRO) burden of highâtouch common area and rehabilitation gym surfaces, and to assess microorganism transfer potential during rehabilitation sessions.
DESIGN
Prospective study of environmental contamination.
SETTING
Nursing home (NH).
PARTICIPANTS
Six Michigan NHs.
MEASUREMENTS
Monthly samples from common area surfaces (eg, living room), rehabilitation equipment, and rehabilitation personnel hands were screened for methicillinâresistant Staphylococcus aureus (MRSA), vancomycinâresistant enterococci (VRE), and resistant gramânegative bacilli (RâGNB). To assess microorganism transfer potential, we conducted an inâdepth assessment of microorganism transfer during 10 rehabilitation sessions. Microorganism transfer was defined as the identification of a microorganism on a destination surface that was uncontaminated before the rehabilitation session. Patient frequency of common area usage was also assessed qualitatively.
RESULTS
We obtained 1338 common area specimens from 180 monthly facility visits, of which 13.4% (179/1338) were MDRO positive: MRSA, 3.8%; VRE, 5.8%; and RâGNB, 5.1%. A total of 64% (116/180) of sampling visits had at least one MDROâpositive common area specimen. Within rehabilitation gyms, we obtained 521 equipment and 190 personnel hand specimens during 60 monthly visits. Of the equipment specimens collected, 7.7% (40/521) were MDRO positive: MRSA, 2.5%; VRE, 4.0%; and RâGNB, 1.9%. Of the 190 rehabilitation personnel hand specimens collected, 3.7% (7/190) were MDRO positive. Overall, 55% (33/60) of rehabilitation gym visits had at least one MDROâpositive specimen. Microorganism transfer assessment during 10 rehabilitation sessions revealed 35 opportunities for transfer during which microorganism transfer occurred in 17.1% (6/35) of opportunities.
CONCLUSION
NH common areas and rehabilitation gyms are MDRO reservoirs that may contribute to the transmission of healthcareâassociated pathogens. Because NHs accommodate the increasing shortâstay patient population, developing effective interventions that reduce MDRO transmission in the common area and rehabilitation gym environment should be considered an infection prevention priority. J Am Geriatr Soc 68:478â485, 2020