Journal article
Transfer of multidrug-resistant bacteria to healthcare workers' gloves and gowns after patient contact increases with environmental contamination
Critical care medicine, Vol.40(4), pp.1045-1051
04/2012
DOI: 10.1097/CCM.0b013e31823bc7c8
PMCID: PMC3534819
PMID: 22202707
Abstract
To assess the role of environmental contamination in the transmission of multidrug-resistant bacteria to healthcare workers' clothing. Prospective cohort. Six intensive care units at a tertiary care hospital. Healthcare workers including registered nurses, patient care technicians, respiratory therapists, occupational/physical therapists, and physicians. None. One hundred twenty of 585 (20.5%) healthcare worker/patient interactions resulted in contamination of healthcare workers' gloves or gowns. Multidrug-resistant Acinetobacter baumannii contamination occurred most frequently, 55 of 167 observations (32.9%; 95% confidence interval [CI] 25.8% to 40.0%), followed by multidrug-resistant Pseudomonas aeruginosa, 15 of 86 (17.4%; 95% CI 9.4% to 25.4%), vancomycin-resistant Enterococcus, 25 of 180 (13.9%, 95% CI 8.9, 18.9%) and methicillin-resistant Staphylococcus aureus, 21 of 152 (13.8%; 95% CI 8.3% to 19.2%). Independent risk factors associated with healthcare worker contamination with multidrug-resistant bacteria were positive environmental cultures (odds ratio [OR] 4.2; 95% CI 2.7-6.5), duration in room for >5 mins (OR 2.0; 95% CI 1.2-3.4), performing physical examinations (OR 1.7; 95% CI 1.1-2.8), and contact with the ventilator (OR 1.8; 95% CI, 1.1-2.8). Pulsed field gel electrophoresis determined that 91% of healthcare worker isolates were related to an environmental or patient isolate. The contamination of healthcare workers' protective clothing during routine care of patients with multidrug-resistant organisms is most frequent with A. baumannii. Environmental contamination was the major determinant of transmission to healthcare workers' gloves or gowns. Compliance with contact precautions and more aggressive environmental cleaning may decrease transmission.
Details
- Title: Subtitle
- Transfer of multidrug-resistant bacteria to healthcare workers' gloves and gowns after patient contact increases with environmental contamination
- Creators
- Daniel J Morgan - Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. dmorgan@epi.umaryland.eduElizabeth RogawskiKerri A ThomJ Kristie JohnsonEli N PerencevichMichelle ShardellSurbhi LeekhaAnthony D Harris
- Resource Type
- Journal article
- Publication Details
- Critical care medicine, Vol.40(4), pp.1045-1051
- DOI
- 10.1097/CCM.0b013e31823bc7c8
- PMID
- 22202707
- PMCID
- PMC3534819
- NLM abbreviation
- Crit Care Med
- ISSN
- 1530-0293
- eISSN
- 1530-0293
- Publisher
- United States
- Grant note
- 5K24AI079040-02 / NIAID NIH HHS K23 AI082450 / NIAID NIH HHS K24 AI079040 / NIAID NIH HHS 1 K08 HS18111-01 / AHRQ HHS K08 HS018111 / AHRQ HHS
- Comment
- The authors have not disclosed any potential conflicts of interest.
- Language
- English
- Date published
- 04/2012
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983779293002771
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