Assessment of Antibiotic Resistant Organism Transmission between Rooms of Hospitalized Patients, Healthcare Professionals, and the Hospital Environment Utilizing Surrogate Markers and Selective Bacterial Cultures

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Kwon, Jennie H. ; Reske, Kimberly ; O’Neil, Caroline A. ; Cass, Candice ; Seiler, Sondra ; Wallace, Meghan A. ; Hink, Tiffany ; Liang, Stephen Y. ; Fraser, Victoria J. ; Burnham, Carey-Ann D. ; Dubberke, Erik R.
• Corporate Authors:
  CDC Prevention Epicenters Program
• Description:
  Objective:
  
  To assess potential transmission of antibiotic resistant organisms (AROs) using surrogate markers and bacterial cultures.
  
  Design:
  
  pilot study.
  
  Setting:
  
  1,260-bed tertiary-care academic medical center.
  
  Participants:
  
  25 patients (17 on contact precautions for AROs) and 77 healthcare professionals (HCPs).
  
  Methods:
  
  Fluorescent powder (FP) and MS2 bacteriophage were applied in patient rooms. HCP visits to each room were observed for 2–4 hours; hand hygiene (HH) compliance was recorded. Surfaces in and outside the room and HCP skin/clothing were assessed for fluorescence and swabs were collected for MS2 detection by PCR and selective bacterial cultures.
  
  Results:
  
  Transfer of FP was observed for 20 (80%) rooms and 26 (34%) HCPs. Transfer of MS2 was detected for 10 (40%) rooms and 15 (19%) HCPs. Bacterial cultures were positive for one room and 8 (10%) HCPs. Interactions with patients on contact precautions resulted in fewer FP detections than interactions with patients not on precautions (p<.001); MS2 detections did not differ by patient isolation status. FP detections did not differ by type of HCP, but MS2 was recovered more frequently from physicians vs. nurses (p=0.03). HH compliance was better among HCPs caring for patients on contact precautions vs. HCPs caring for patients not on precautions (p=0.003), among nurses vs. other non-physician HCPs at room entry (p=0.002), and among nurses vs. physicians at room exit (p=0.03). HCPs who performed HH prior to assessment had fewer fluorescence detections (p=0.008).
  
  Conclusions:
  
  Contact precautions were associated with greater HCP HH compliance and reduced detection of FP and MS2.
  
  
• Subjects:
  Academic Medical Centers Bacteriophages Cross Infection Drug Resistance, Multiple, Bacterial Equipment Contamination Guideline Adherence Hand Hygiene Health Personnel Hospitalization Hospitals Humans Patients Pilot Projects

  More +
• Source:
  Infect Control Hosp Epidemiol. 41(5):539-546
• Pubmed ID:
  31969206
• Pubmed Central ID:
  PMC7592156
• Document Type:
  Journal Article
• Funding:
  K23 AI137321/AI/NIAID NIH HHSUnited States/ ; U54 CK000609/CK/NCEZID CDC HHSUnited States/ ; U54 CK000162/CK/NCEZID CDC HHSUnited States/ ; UL1 TR002345/TR/NCATS NIH HHSUnited States/ ; KL2 TR000450/TR/NCATS NIH HHSUnited States/ ; KL2 TR002346/TR/NCATS NIH HHSUnited States/ ; UL1 TR000448/TR/NCATS NIH HHSUnited States/
• Volume:
  41
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d1ffe4e7b20bb2508dce7e88c204a80514fd39b1485e31e160f7ad46c818dfe3
• Download URL:
  https://stacks.cdc.gov/view/cdc/105686/cdc_105686_DS1.pdf
• File Type:
  [PDF - 176.36 KB ]