Perception vs Reality: Methicillin-Resistant <i>Staphylococcus aureus</i> Carriage Among Healthcare Workers at a Veterans Affairs Medical Center

Colburn, Nora; Cadnum, Jennifer L.; Flannery, Elizabeth; Chang, Shelley; Donskey, Curtis J.; Stiefel, Usha

doi:10.1017/ice.2015.242

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Our study advances this literature now in hospitals [32] by showing that the rates of patient hand contamination with an MDRO on admission to a hospital are high and new acquisition is frequent, perhaps surpassing that of HCP [25, 26]. In emerging healthcare systems where there is emphasis for early mobility, financial penalties for adverse events related to immobility and falls, and frequent treatment or procedures out of the room, patient hand contamination can have significant implications on MDRO transmission with both near and far environmental surfaces.…”

Section: Discussionmentioning

confidence: 74%

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Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

Mody

Washer

Kaye

et al. 2019

Clinical Infectious Diseases

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BackgroundThe impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role of patient hand contamination needs to be characterized further.MethodsPatients from 2 hospitals in southeast Michigan were recruited within 24 hours of arrival to their room and followed prospectively using microbial surveillance of nares, dominant hand, and 6 high-touch environmental surfaces. Sampling was performed on admission, days 3 and 7, and weekly until discharge. Paired samples of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the patients’ hand and room surfaces were evaluated for relatedness using pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec, and Panton-Valentine leukocidin typing.ResultsA total of 399 patients (mean age, 60.8 years; 49% male) were enrolled and followed for 710 visits. Fourteen percent (n = 56/399) of patients were colonized with an MDRO at baseline; 10% (40/399) had an MDRO on their hands. Twenty-nine percent of rooms harbored an MDRO. Six percent (14/225 patients with at least 2 visits) newly acquired an MDRO on their hands during their stay. New MDRO acquisition in patients occurred at a rate of 24.6/1000 patient-days, and in rooms at a rate of 58.6/1000 patient-days. Typing demonstrated a high correlation between MRSA on patient hands and room surfaces.ConclusionsOur data suggest that patient hand contamination with MDROs is common and correlates with contamination on high-touch room surfaces. Patient hand hygiene protocols should be considered to reduce transmission of pathogens and healthcare-associated infections.

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Section: Discussionmentioning

confidence: 74%

“…Numerous studies show that on average, about 5% of HCP hands are contaminated with an MDRO [25–27], the most common being MRSA, VRE, and RGNB, such as Acinetobacter species and Pseudomonas aeruginosa [27]. Research on patient hand contamination by pathogens is now emerging [6, 7, 21, 28–31].…”

Section: Discussionmentioning

confidence: 99%

Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

Mody

Washer

Kaye

et al. 2019

Clinical Infectious Diseases

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“…Twenty (33.9%) of the studies were performed after sampling HCP hands on general wards, 38,[42][43][44]47,48,51,55,56,61,67,71,73,74,77,78,85,86,89,92 42,44,46,56,60,[62][63][64]71,72,77,82,85 swab was used in 7 (11.9%), 38,47,49,65,73,75,86 and subungual scraping was used in 1 (1.7%). 61 One study did not specify a collection method.…”

Section: Search Results and Study Detailsmentioning

confidence: 99%

How often are health care personnel hands colonized with multidrug- resistant organisms? A systematic review and meta-analysis

Montoya

Schildhouse

Goyal

et al. 2019

American Journal of Infection Control

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Background: Hands of health care personnel (HCP) can transmit multidrug-resistant organisms (MDROs), resulting in infections. Our aim was to determine MDRO prevalence on HCP hands in adult acute care and nursing facility settings. Methods: A systematic search of PubMed/MEDLINE, Web of Science, CINAHL, Embase, and Cochrane CEN-TRAL was performed. Studies were included if they reported microbiologic culture results following HCP hands sampling; included prevalent MDROs, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, Clostridium difficile, Acinetobacter baumannii, or Pseudomonas aeruginosa, and were conducted in acute care or nursing facility settings. Results: Fifty-nine articles comprising 6,840 hand cultures were included. Pooled prevalence for MRSA, P aeruginosa, A baumannii, and vancomycin-resistant Enterococcus were 4.26%, 4.59%, 6.18%, and 9.03%, respectively. Substantial heterogeneity in rates of pathogen isolation were observed across studies (I 2 = 81%-95%). Only 4 of 59 studies sampled for C difficile, with 2 of 4 finding no growth. Subgroup analysis of MRSA revealed the highest HCP hand contamination rates in North America (8.28%). Sample collection methods used were comparable for MRSA isolation (4%-7%) except for agar direct contact (1.55%). Conclusions: Prevalence of common MDROs on HCP hands vary by pathogen, care setting, culture acquisition method, study design, and geography. When obtained at an institutional level, these prevalence data can be utilized to enhance knowledge, practice, and research to prevent health care−associated infections.

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“…Σημαντικό δείκτη ποιότητας και υγιεινής των νοσοκομείων αποτελούν τα ποσοστά ανίχνευσης στελεχών MRSA (Dancer, 2001). Πρόσφατη μελέτη, που έλαβε χώρα στις ΗΠΑ, ανέφερε επιπολασμό MRSA 6,2% στα χέρια των εργαζομένων σε μονάδα υγειονομικής περίθαλψης (Colburn et al, 2016) (Tacconelli & Cataldo, 2008), (Ott & Wirick, 2008 (Chun, Kim, & Park, 2015). Ξέσπασμα επιδημίας από πολυανθεκτικά στελέχη Acinetobacter baumannii σε Μονάδα Εντατικής Θεραπείας Ελληνικού νοσοκομείου σταμάτησε μετά την εφαρμογή μέτρων υγιεινής των χεριών, καθαρισμού και απολύμανσης του χώρου (Kraniotaki et al, 2006).…”

Section: άψυχο και έμψυχο περιβάλλονunclassified

Αποικισμός Πολυανθεκτικών Στελεχών Σε Νοσοκομειακούς Χώρους Και Ο Ρόλος Των Εργαζομένων Στην Οριζόντια Μετάδοσή Τους

Tselebonis¹,

Τσελεμπόνης²

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Η παρούσα διατριβή είχε ως στόχο την καταγραφή του ολικού μικροβιακού φορτίου και την ταυτόχρονη μελέτη ευαισθησίας στις αντιμικροβιακές ουσίες των συχνότερων Gram αρνητικών και Gram θετικών μικροοργανισμών που απομονώνονται από το περιβάλλον του νοσοκομείου. Το υλικό της έρευνας αποτέλεσαν καλλιέργειες οι οποίες απομονώθηκαν από τα δείγματα του άψυχου (αέρας, επιφάνειες) και έμψυχου περιβάλλοντος (χέρια του ιατρικού και νοσηλευτικού προσωπικού), σε τέσσερις κλινικές του Πανεπιστημιακού Γενικού Νοσοκομείου Έβρου. Συνολικά, ελήφθησαν 402 δείγματα, 125 δείγματα από το έμψυχο περιβάλλον και 277 από το άψυχο περιβάλλον. Ο έλεγχος ευαισθησίας στις αντιμικροβιακές ουσίες υλοποιήθηκε με δύο μεθόδους: α) με τον αυτοματοποιημένο αναλυτή Vitek 2 (Biomerieux) για την εκτίμηση ελάχιστης ανασταλτικής συγκέντρωσης ΜΙC με τη χρήση ειδικών καρτών και β) με τη μέθοδο E-test. Η στατιστική ανάλυση των αποτελεσμάτων έγινε με τη βοήθεια του στατιστικού πακέτου IBM SPSS v. 17.0.Από το έμψυχο περιβάλλον απομονώθηκαν 94 στελέχη (75,2%), εκ των οποίων τα 37 χαρακτηρίστηκαν πολυανθεκτικά (39,4%). Το ποσοστό αυτό αντιστοιχεί στο 29,6% επί του συνόλου των δειγμάτων του έμψυχου περιβάλλοντος.Από το άψυχο περιβάλλον απομονώθηκαν 106 στελέχη (38,3%) εκ των οποίων τα 24, χαρακτηρίστηκαν πολυανθεκτικά, (22,6%). Το ποσοστό αυτό αντιστοιχεί στο 8,7% επί του συνόλου των δειγμάτων του άψυχου περιβάλλοντοςΗ γενετική ανάλυση των περιβαλλοντικών στελεχών οδήγησε στα εξής συμπεράσματα αναφορικά με τη μοριακή επιδημιολογία τους. Τα επιδημιολογικά στελέχη έχουν το ίδιο γενετικό αποτύπωμα, ενώ τα σποραδικά εμφανιζόμενα και τα μη σχετιζόμενα επιδημιολογικά στελέχη παρουσιάζουν σταθερά γενετική ετερογένεια.

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Perception vs Reality: Methicillin-Resistant Staphylococcus aureus Carriage Among Healthcare Workers at a Veterans Affairs Medical Center

Cited by 3 publications

References 8 publications

Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

How often are health care personnel hands colonized with multidrug- resistant organisms? A systematic review and meta-analysis

Αποικισμός Πολυανθεκτικών Στελεχών Σε Νοσοκομειακούς Χώρους Και Ο Ρόλος Των Εργαζομένων Στην Οριζόντια Μετάδοσή Τους

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