TY - JOUR
T1 - Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes
AU - Pineles, Lisa
AU - Morgan, Daniel J.
AU - Lydecker, Alison
AU - Johnson, J. Kristie
AU - Sorkin, John D.
AU - Langenberg, Patricia
AU - Blanco, Natalia
AU - Lesse, Alan
AU - Sellick, John
AU - Gupta, Kalpana
AU - Leykum, Luci
AU - Cadena, Jose
AU - Lepcha, Nickie
AU - Roghmann, Mary Claire
N1 - Publisher Copyright:
© 2017
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background This was an observational study designed to estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by health care workers (HCWs) interacting with Veterans Affairs Community Living Center (VA nursing home) residents to inform MRSA prevention policies. Methods Participants included residents and HCWs from 7 VA nursing homes in 4 states and Washington, DC. Residents were cultured for MRSA at the anterior nares, perianal skin, and wound (if present). HCWs wore gowns and gloves during usual care activities. After each activity, a research coordinator swabbed the HCW's gown and gloves. Swabs were cultured for MRSA. Results There were 200 residents enrolled; 94 (46%) were MRSA colonized. Glove contamination was higher than gown contamination (20% vs 11%, respectively; P <.01). Transmission varied greatly by type of care from 0%-19% for gowns and 7%-37% for gloves. High-risk care activities (odds ratio [OR] > 1.0, P <.05) for gown contamination included changing dressings (eg, wound), dressing, providing hygiene (eg, brushing teeth), and bathing. Low-risk care activities (OR < 1.0, P <.05 or no transmission) for gown contamination included glucose monitoring, giving medications, and feeding. Conclusions MRSA transmission from colonized residents to gloves was higher than transmission to gowns. Transmission to gloves varies by type of care, but all care had a risk of contamination, demonstrating the importance of hand hygiene after all care. Transmission to gowns was significantly higher with certain types of care. Optimizing gown and glove use by targeting high-risk care activities could improve resident-centered care for MRSA-colonized residents by promoting a home-like environment.
AB - Background This was an observational study designed to estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by health care workers (HCWs) interacting with Veterans Affairs Community Living Center (VA nursing home) residents to inform MRSA prevention policies. Methods Participants included residents and HCWs from 7 VA nursing homes in 4 states and Washington, DC. Residents were cultured for MRSA at the anterior nares, perianal skin, and wound (if present). HCWs wore gowns and gloves during usual care activities. After each activity, a research coordinator swabbed the HCW's gown and gloves. Swabs were cultured for MRSA. Results There were 200 residents enrolled; 94 (46%) were MRSA colonized. Glove contamination was higher than gown contamination (20% vs 11%, respectively; P <.01). Transmission varied greatly by type of care from 0%-19% for gowns and 7%-37% for gloves. High-risk care activities (odds ratio [OR] > 1.0, P <.05) for gown contamination included changing dressings (eg, wound), dressing, providing hygiene (eg, brushing teeth), and bathing. Low-risk care activities (OR < 1.0, P <.05 or no transmission) for gown contamination included glucose monitoring, giving medications, and feeding. Conclusions MRSA transmission from colonized residents to gloves was higher than transmission to gowns. Transmission to gloves varies by type of care, but all care had a risk of contamination, demonstrating the importance of hand hygiene after all care. Transmission to gowns was significantly higher with certain types of care. Optimizing gown and glove use by targeting high-risk care activities could improve resident-centered care for MRSA-colonized residents by promoting a home-like environment.
KW - MRSA
KW - Nursing home
KW - Transmission
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U2 - 10.1016/j.ajic.2017.03.004
DO - 10.1016/j.ajic.2017.03.004
M3 - Article
C2 - 28431853
AN - SCOPUS:85017534634
SN - 0196-6553
VL - 45
SP - 947
EP - 953
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 9
ER -