Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes

Lisa Pineles, Daniel J. Morgan, Alison Lydecker, J. Kristie Johnson, John D. Sorkin, Patricia Langenberg, Natalia Blanco, Alan Lesse, John Sellick, Kalpana Gupta, Luci Leykum, Jose Cadena, Nickie Lepcha, Mary Claire Roghmann

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)947-953
Number of pages7
JournalAmerican Journal of Infection Control
Volume45
Issue number9
DOIs
StatePublished - Sep 1 2017

Keywords

  • MRSA
  • Nursing home
  • Transmission

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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