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

Details

• Journal Article:
  Infect Control Hosp Epidemiol
• Personal Author:
  Jackson, Sarah S. ; Thom, Kerri A. ; Magder, Laurence S. ; Stafford, Kristen A. ; Johnson, J. Kristie ; Miller, Loren G. ; Calfee, David P. ; Harris, Anthony D.
• Corporate Authors:
  CDC Prevention Epicenters Program
• Description:
  Objective: ; To determine which healthcare worker (HCW) roles and patient care activities are associated with acquisition of vancomycin-resistant Enterococcus (VRE) on HCW gloves or gowns after patient care, as a surrogate for transmission to other patients. ; Design: ; Prospective cohort study. ; Setting: ; Medical and surgical intensive care units at a tertiary-care academic institution. ; Participants: ; VRE-colonized patients on Contact Precautions and their HCWs. ; Methods: ; Overall, 94 VRE-colonized patients and 469 HCW–patient interactions were observed. Research staff recorded patient care activities and cultured HCW gloves and gowns for VRE before doffing and exiting patient room. ; Results: ; VRE were isolated from 71 of 469 HCWs’ gloves or gowns (15%) following patient care. Occupational/physical therapists, patient care technicians, nurses, and physicians were more likely than environmental services workers and other HCWs to have contaminated gloves or gowns. Compared to touching the environment alone, the odds ratio (OR) for VRE contamination associated with touching both the patient (or objects in the immediate vicinity of the patient) and environment was 2.78 (95% confidence interval CI, 0.99–0.77) and the OR associated with touching only the patient (or objects in the immediate vicinity) was 3.65 (95% CI, 1.17–11.41). Independent risk factors for transmission of VRE to HCWs were touching the patient’s skin (OR, 2.18; 95% CI, 1.15–4.13) and transferring the patient into or out of bed (OR, 2.66; 95% CI, 1.15–6.43). ; Conclusion: ; 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.
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• Keywords:
  • Aged
  • Cross Infection
  • Equipment Contamination
  • Female
  • Gloves, Protective
  • Gram-Positive Bacterial Infections
  • Health Personnel
  • Humans
  • Infectious Disease Transmission, Professional-to-Patient
  • Intensive Care Units
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• Source:
  Infect Control Hosp Epidemiol. 39(9):1063-1067
• DOI:
  http://dx.doi.org/10.1017/ice.2018.160
• Pubmed ID:
  30051793
• Pubmed Central ID:
  PMC6442931
• Document Type:
  Text ; Journal Article
• Funding:
  R01 AI121146/AI/NIAID NIH HHSUnited States/ ; U54 CK000450/CK/NCEZID CDC HHSUnited States/ ; U54CK000450/ACL/ACL HHSUnited States/
• Genre:
  Journal Article
• Volume:
  39
• Issue:
  9
• Download URL:
  https://stacks.cdc.gov/view/cdc/77172/cdc_77172_DS1.pdf
• File Type:
  [PDF - 407.06 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:ca7781140d80c6f110e8a8e094597197fdca79e2f176c9b0f10998d8aeb8cc3080ed9f3c77dc5d803da3c0c0a06dde707ecaf62f234a39b2dd4d81e66dab4fca