Details:

Alternative Title:
Am J Infect Control
Personal Author:
Jackson, Sarah S. ; Harris, Anthony D. ; Magder, Laurence S. ; Stafford, Kristen A. ; Johnson, J. Kristie ; ... More +
Jackson, Sarah S. ; Harris, Anthony D. ; Magder, Laurence S. ; Stafford, Kristen A. ; Johnson, J. Kristie ; Miller, Loren G. ; Calfee, David P. ; Thom, Kerri A. Less -
Corporate Authors:
CDC Prevention Epicenters Program
Description:
Background

Healthcare workers (HCWs) are significant vectors for transmission of multidrug- resistant organisms among patients in intensive care units (ICUs). We studied ICU patients on Contact Precautions, colonized with vancomycin-resistant Enterococcus (VRE) to assess whether bacterial burden is associated with transmission to HCWs’ gloves or gowns, a surrogate outcome for transmission to subsequent patients.

Methods:

From this prospective cohort study we analyzed 96 VRE colonized ICU patients and five HCWs per patient. We obtained samples from patients’ perianal, skin, and stool to assess bacterial burden and cultured HCWs’ gloves and gowns for VRE after patient care.

Results

Seventy-one of 479 (15%) HCW-patient interactions led to HCWs’ glove or gown contamination with VRE. HCW contamination was associated with VRE burden on the perianal swab (OR: 1.37 [95% CI 1.19, 1.57]); skin swabs (OR: 2.14 [95% CI: 1.51, 3.02)]; and in stool (OR: 1.95 [95% CI: 1.39, 2.72]). Compared to colonization with E. faecalis, colonization with E. faecium was associated with higher bacterial burden and higher odds of transmission to HCWs.

Discussion

We show that ICU patients with higher bacterial burden are more likely to transmit VRE to HCWs. These findings have implications for VRE de-colonization and other infection control interventions.


Subject:
[+]
Article
Bacterial Burden
Contact Precautions
Healthcare Workers
Vancomycin-resistant Enterococcus

Source:
Am J Infect Control. 47(1):13-17
Pubmed ID:
30268592
Pubmed Central ID:
PMC6452858
Document Type:
Journal Article
Funding:
R01 AI121146/AI/NIAID NIH HHS/United States ; U54 CK000450/CK/NCEZID CDC HHS/United States ; U54CK000450/ACL HHS/United States
R01 AI121146/AI/NIAID NIH HHS/United States ; U54 CK000450/CK/NCEZID CDC HHS/United States ; U54CK000450/ACL HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:8cf4541a95ad7c3b4d9ce62886e6e46b2b31859b36b7719669aa19ce4d85ddf9
File Type:

Supporting Files

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