Details:

Alternative Title:
Infect Control Hosp Epidemiol
Personal Author:
Chen, Luke F. ; Knelson, Lauren P. ; Gergen, Maria F. ; Better, Olga M. ; Nicholson, Bradly P. ; ... More +
Chen, Luke F. ; Knelson, Lauren P. ; Gergen, Maria F. ; Better, Olga M. ; Nicholson, Bradly P. ; Woods, Christopher W. ; Rutala, William A. ; Weber, David J. ; Sexton, Daniel J. ; Anderson, Deverick J. Less -
Corporate Authors:
for the CDC Prevention Epicenters Program sites and hospitalized patients—the TransFER study
Description:
Objective

Hospital environmental surfaces are frequently contaminated by microorganisms. However, the causal mechanism of bacterial contamination of the environment as a source of transmission is still debated. This prospective study was performed to characterize the nature of multidrug-resistant organism (MDRO) transmission between the environment and patients using standard microbiological and molecular techniques.

Setting

Prospective cohort study at 2 academic medical centers.

Design

A prospective multicenter study to characterize the nature of bacterial transfer events between patients and environmental surfaces in rooms that previously housed patients with 1 of 4 ‘marker’ MDROs: methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, and MDR Acinetobacter baumannii. Environmental and patient microbiological samples were obtained on admission into a freshly disinfected inpatient room. Repeat samples from room surfaces and patients were taken on days 3 and 7 and each week the patient stayed in the same room. The bacterial identity, antibiotic susceptibility, and molecular sequences were compared between organisms found in the environment samples and patient sources.

Results

We enrolled 80 patient–room admissions; 9 of these patients (11.3%) were asymptomatically colonized with MDROs at study entry. Hospital room surfaces were contaminated with MDROs despite terminal disinfection in 44 cases (55%). Microbiological Bacterial Transfer events either to the patient, the environment, or both occurred in 12 patient encounters (18.5%) from the microbiologically evaluable cohort.

Conclusions

Microbiological Bacterial Transfer events between patients and the environment were observed in 18.5% of patient encounters and occurred early in the admission. This study suggests that research on prevention methods beyond the standard practice of room disinfection at the end of a patient’s stay is needed to better prevent acquisition of MDROs through the environment.


Subject:
[+]
Aged
Article
Cross Infection
Disinfection
Drug Resistance, Multiple, Bacterial
Equipment And Supplies, Hospital
Equipment Contamination
Female
Gram-Negative Facultatively Anaerobic Rods
Gram-Positive Endospore-Forming Rods
Health Facilities
Humans
Male
Middle Aged
North Carolina
Patients' Rooms
Prospective Studies

Source:
Infect Control Hosp Epidemiol. 40(1):47-52
Pubmed ID:
30426908
Pubmed Central ID:
PMC6690181
Document Type:
Journal Article
Funding:
K23 AI095357/AI/NIAID NIH HHS/United States ; U54 CK000164/CK/NCEZID CDC HHS/United States ; U54 CK000483/CK/NCEZID CDC HHS/United States
K23 AI095357/AI/NIAID NIH HHS/United States ; U54 CK000164/CK/NCEZID CDC HHS/United States ; U54 CK000483/CK/NCEZID CDC HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:8b2706e85d74b696a28b6ce182b065d4804d3aaf685838242a6d3a81a2d21c72
File Type:

Supporting Files

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  	NIHMS1043605-supplement-Supplement_Appendix.docx	docx

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