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Risk factors for transmission of carbapenem-resistant Enterobacteriaceae to healthcare personnel gloves and gowns in the United States
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3 2021
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Source: J Hosp Infect. 109:58-64
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Alternative Title:J Hosp Infect
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Description:Background
Hospitals are sources for acquisition of carbapenem-resistant Enterobacteriaceae (CRE), and it is believed that the contamination of healthcare personnel (HCP) hands and clothing play a major role in patient-to-patient transmission of antibiotic-resistant bacteria.
Aim
The aim of this study was to determine which HCP types, HCP-patient interactions, and patient characteristics are associated with greater transmission of CRE to HCP gloves and gowns in the hospital.
Methods
This was a prospective observational cohort study that enrolled patients with recent surveillance or clinical cultures positive for CRE at five hospitals in four states in the United States. HCP gloves and gown were cultured after patient care. Samples were also obtained from patients’ stool, perianal area, and skin of the chest and arm to assess bacterial burden.
Results
Among 313 CRE-colonized patients and 3070 glove and gown cultures obtained after patient care, we found that HCP gloves and gowns were contaminated with CRE 7.9% and 4.3% of the time, respectively. Contamination of either gloves or gowns occurred in 10.0% of interactions. Contamination was highest (15.3%) among respiratory therapists (OR: 3.79, 95% CI: 1.61- 8.94) and when any HCP touched the patient (OR: 1.52, 95% CI: 1.10-2.12). We also found associations between being in the ICU, having a positive clinical culture, and increasing bacterial burden on the patient and CRE transmission to HCP gloves or gown.
Conclusion
CRE transmission to HCP gloves and gown occurred frequently. These findings may inform evidence-based policies about what situations and for which patients contact precautions are most critical.
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Pubmed ID:33358930
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Pubmed Central ID:PMC8211026
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Volume:109
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