Patient contact is the main risk factor for vancomycin-resistant <i>Enterococcus</i> contamination of healthcare workers’ gloves and gowns in the intensive care unit

Jackson, Sarah; Thom, Kerri A.; Magder, Laurence S.; Stafford, Kristen A.; Johnson, J. Kristie; Miller, Loren G.; Calfee, David P.; Harris, Anthony D.; Program, Cdc Prevention Epicenters

doi:10.1017/ice.2018.160

Cited by 21 publications

(18 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Potential exposure to mucous membranes or body fluid among these activities is variable; sustained patient contact may be a more important risk factor for ARO acquisition among HCP in the NF setting; however, further studies are needed. 25,26 Molecular typing to characterize AROs isolated from patients and their environment in close temporal relationship to HCP ARO acquisitions will be important to establish which transmission pathways are most common and thus should be targeted in future interventions.…”

Section: Discussionmentioning

confidence: 99%

The devil is in the details: Factors influencing hand hygiene adherence and contamination with antibiotic-resistant organisms among healthcare providers in nursing facilities

Mills

Zhu

Mantey

et al. 2019

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Background:Antibiotic-resistant organism (ARO) colonization rates in skilled nursing facilities (NFs) are high; hand hygiene is crucial to interrupt transmission. We aimed to determine factors associated with hand hygiene adherence in NFs and to assess rates of ARO acquisition among healthcare personnel (HCP).Methods:HCP were observed during routine care at 6 NFs. We recorded hand hygiene adherence, glove use, activities, and time in room. HCP hands were cultured before and after patient care; patients and high-touch surfaces were cultured. HCP activities were categorized as high-versus low-risk for self-contamination. Multivariable regression was performed to identify predictors of hand hygiene adherence.Results:We recorded 385 HCP observations and paired them with cultures performed before and after patient care. Hand hygiene adherence occurred in 96 of 352 observations (27.3%) before patient care and 165 of 358 observations (46.1%) after patient care. Gloves were worn in 169 of 376 observations (44.9%). Higher adherence was associated with glove use before patient care (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.44–4.54) and after patient care (OR, 3.11; 95% CI, 1.77–5.48). Compared with nurses, certified nurse assistants had lower hand hygiene adherence (OR, 0.31; 95% CI, 0.15–0.67) before patient care and physical/occupational therapists (OR, 0.22; 95% CI, 0.11–0.44) after patient care. Hand hygiene varied by activity performed and time in the room. HCP hands were contaminated with AROs in 35 of 385 cultures of hands before patient care (0.9%) and 22 of 350 cultures of hands after patient care (6.3%).Conclusions:Hand hygiene adherence in NFs remain low; it is influenced by job title, type of care activity, and glove use. Hand hygiene programs should incorporate these unique care and staffing factors to reduce ARO transmission.

show abstract

Section: Discussionmentioning

confidence: 99%

The devil is in the details: Factors influencing hand hygiene adherence and contamination with antibiotic-resistant organisms among healthcare providers in nursing facilities

Mills

Zhu

Mantey

et al. 2019

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…Using a twirling motion, the swab was rubbed along each finger and the palm of both gloved hands. HCP gowns were sampled twice along both forearms and then in a “W” pattern along the beltline as done in previous studies [4, 5, 13, 14]. To quantify MRSA burden on a subset of patients, we used ESwabs (Copan Diagnostics, Murrieta, CA) to swab the patient’s anterior nares and skin in the perianal region.…”

Section: Methodsmentioning

confidence: 99%

Optimizing Contact Precautions to Curb the Spread of Antibiotic-resistant Bacteria in Hospitals: A Multicenter Cohort Study to Identify Patient Characteristics and Healthcare Personnel Interactions Associated With Transmission of Methicillin-resistant Staphylococcus aureus

O’Hara

Calfee

Miller

et al. 2019

Clinical Infectious Diseases

View full text Add to dashboard Cite

Background Healthcare personnel (HCP) acquire antibiotic-resistant bacteria on their gloves and gowns when caring for intensive care unit (ICU) patients. Yet, contact precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA) remains controversial despite existing guidelines. We sought to understand which patients are more likely to transfer MRSA to HCP and to identify which HCP interactions are more likely to lead to glove or gown contamination. Methods This was a prospective, multicenter cohort study of cultured HCP gloves and gowns for MRSA. Samples were obtained from patients’ anterior nares, perianal area, and skin of the chest and arm to assess bacterial burden. Results Among 402 MRSA-colonized patients with 3982 interactions, we found that HCP gloves and gowns were contaminated with MRSA 14.3% and 5.9% of the time, respectively. Contamination of either gloves or gowns occurred in 16.2% of interactions. Contamination was highest among occupational/physical therapists (odds ratio [OR], 6.96; 95% confidence interval [CI], 3.51, 13.79), respiratory therapists (OR, 5.34; 95% CI, 3.04, 9.39), and when any HCP touched the patient (OR, 2.59; 95% CI, 1.04, 6.51). Touching the endotracheal tube (OR, 1.75; 95% CI, 1.38, 2.19), bedding (OR, 1.43; 95% CI, 1.20, 1.70), and bathing (OR, 1.32; 95% CI, 1.01, 1.75) increased the odds of contamination. We found an association between increasing bacterial burden on the patient and HCP glove or gown contamination. Conclusions Gloves and gowns are frequently contaminated with MRSA in the ICU. Hospitals may consider using fewer precautions for low-risk interactions and more for high-risk interactions and personnel.

show abstract

“…Durch Desinfektion konnten dabei nur 50 % der Darmbakterien vom Equipment beseitigt werden [16]. Die Berührung per se gilt als wichtige Übertragungsquelle [17] [18]. Es bedarf der regelmäßigen Qualitätskontrolle und der interprofessionellen Zusammenarbeit, um die Umsetzung der Bundlesinsbesondere der Basishygienegemeinsam zu "leben" [19].…”

Section: Kontamination Durch Schutzausrüstungunclassified

Isolieren wir Keime oder Patienten? Isolationsmaßnahmen unter der Lupe

Haeberle¹

2020

Anästhesiol Intensivmed Notfallmed Schmerzther

View full text Add to dashboard Cite

ZusammenfassungIsolationsmaßnahmen zur Prävention der Übertragung multiresistenter Erreger (MRE) gehören in Anbetracht der steigenden Resistenzentwicklung auf Intensivstationen mittlerweile zur Routine. Noch wichtiger sind allerdings Basishygiene und der verantwortungsvolle Umgang mit antiinfektiven Therapien. Dieser Beitrag widmet sich den verschiedenen Präventionsmaßnahmen, die nur in Kombination effektiv und zielführend sind.

show abstract

Patient contact is the main risk factor for vancomycin-resistant Enterococcus contamination of healthcare workers’ gloves and gowns in the intensive care unit

Abstract: Patient contact is a major risk factor for HCW contamination and subsequent transmission. Interventions should prioritize contact precautions and hand hygiene for HCWs whose activities involve touching the patient.

Cited by 21 publications

References 21 publications

The devil is in the details: Factors influencing hand hygiene adherence and contamination with antibiotic-resistant organisms among healthcare providers in nursing facilities

The devil is in the details: Factors influencing hand hygiene adherence and contamination with antibiotic-resistant organisms among healthcare providers in nursing facilities

Optimizing Contact Precautions to Curb the Spread of Antibiotic-resistant Bacteria in Hospitals: A Multicenter Cohort Study to Identify Patient Characteristics and Healthcare Personnel Interactions Associated With Transmission of Methicillin-resistant Staphylococcus aureus

Isolieren wir Keime oder Patienten? Isolationsmaßnahmen unter der Lupe

Contact Info

Product

Resources

About