Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes
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...
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| Veröffentlicht in: | American journal of infection control 2017-09, Vol.45 (9), p.947-953 |
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| creator | Pineles, Lisa, MA Morgan, Daniel J., MD, MS Lydecker, Alison, MPH Johnson, J. Kristie, PhD Sorkin, John D., MD, PhD Langenberg, Patricia, PhD Blanco, Natalia, PhD Lesse, Alan, MD Sellick, John, DO Gupta, Kalpana, MD, MPH Leykum, Luci, MD, MBA, MSc Cadena, Jose, MD Lepcha, Nickie, MD Roghmann, Mary-Claire, MD, MS |
| description | 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 1.0, P |
| doi_str_mv | 10.1016/j.ajic.2017.03.004 |
| format | Article |
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Kristie, PhD ; Sorkin, John D., MD, PhD ; Langenberg, Patricia, PhD ; Blanco, Natalia, PhD ; Lesse, Alan, MD ; Sellick, John, DO ; Gupta, Kalpana, MD, MPH ; Leykum, Luci, MD, MBA, MSc ; Cadena, Jose, MD ; Lepcha, Nickie, MD ; Roghmann, Mary-Claire, MD, MS</creator><creatorcontrib>Pineles, Lisa, MA ; Morgan, Daniel J., MD, MS ; Lydecker, Alison, MPH ; Johnson, J. Kristie, PhD ; Sorkin, John D., MD, PhD ; Langenberg, Patricia, PhD ; Blanco, Natalia, PhD ; Lesse, Alan, MD ; Sellick, John, DO ; Gupta, Kalpana, MD, MPH ; Leykum, Luci, MD, MBA, MSc ; Cadena, Jose, MD ; Lepcha, Nickie, MD ; Roghmann, Mary-Claire, MD, MS</creatorcontrib><description>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.</description><identifier>ISSN: 0196-6553</identifier><identifier>EISSN: 1527-3296</identifier><identifier>DOI: 10.1016/j.ajic.2017.03.004</identifier><identifier>PMID: 28431853</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Cross Infection ; Female ; Health Personnel - organization & administration ; Humans ; Infection Control ; Infection Control - methods ; Infectious Disease ; Infectious Disease Transmission, Patient-to-Professional - prevention & control ; Intensive Care Units ; Male ; Methicillin-Resistant Staphylococcus aureus - pathogenicity ; Methicillin-Resistant Staphylococcus aureus - physiology ; Middle Aged ; MRSA ; Nursing home ; Nursing Homes ; Prospective Studies ; Protective Clothing - microbiology ; Staphylococcal Infections - microbiology ; Staphylococcal Infections - prevention & control ; Staphylococcal Infections - transmission ; Transmission ; United States ; Veterans ; Workforce</subject><ispartof>American journal of infection control, 2017-09, Vol.45 (9), p.947-953</ispartof><rights>2017</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-178ccd0c26f8e2c3b3d82e39c14717a48a5584a385ae6965217cb6023614d3643</citedby><cites>FETCH-LOGICAL-c455t-178ccd0c26f8e2c3b3d82e39c14717a48a5584a385ae6965217cb6023614d3643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0196655317302006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28431853$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pineles, Lisa, MA</creatorcontrib><creatorcontrib>Morgan, Daniel J., MD, MS</creatorcontrib><creatorcontrib>Lydecker, Alison, MPH</creatorcontrib><creatorcontrib>Johnson, J. Kristie, PhD</creatorcontrib><creatorcontrib>Sorkin, John D., MD, PhD</creatorcontrib><creatorcontrib>Langenberg, Patricia, PhD</creatorcontrib><creatorcontrib>Blanco, Natalia, PhD</creatorcontrib><creatorcontrib>Lesse, Alan, MD</creatorcontrib><creatorcontrib>Sellick, John, DO</creatorcontrib><creatorcontrib>Gupta, Kalpana, MD, MPH</creatorcontrib><creatorcontrib>Leykum, Luci, MD, MBA, MSc</creatorcontrib><creatorcontrib>Cadena, Jose, MD</creatorcontrib><creatorcontrib>Lepcha, Nickie, MD</creatorcontrib><creatorcontrib>Roghmann, Mary-Claire, MD, MS</creatorcontrib><title>Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes</title><title>American journal of infection control</title><addtitle>Am J Infect Control</addtitle><description>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.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cross Infection</subject><subject>Female</subject><subject>Health Personnel - organization & administration</subject><subject>Humans</subject><subject>Infection Control</subject><subject>Infection Control - methods</subject><subject>Infectious Disease</subject><subject>Infectious Disease Transmission, Patient-to-Professional - prevention & control</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Methicillin-Resistant Staphylococcus aureus - pathogenicity</subject><subject>Methicillin-Resistant Staphylococcus aureus - physiology</subject><subject>Middle Aged</subject><subject>MRSA</subject><subject>Nursing home</subject><subject>Nursing Homes</subject><subject>Prospective Studies</subject><subject>Protective Clothing - microbiology</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Staphylococcal Infections - prevention & control</subject><subject>Staphylococcal Infections - transmission</subject><subject>Transmission</subject><subject>United States</subject><subject>Veterans</subject><subject>Workforce</subject><issn>0196-6553</issn><issn>1527-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks9u1DAQhy0EotvCC3BAPnJJ8J_YSSSEVFVAkSpxaOFqeZ3JxmnWXjxOq30Y3pVEWzhw4DSXb35jzzeEvOGs5Izr92NpR-9KwXhdMlkyVj0jG65EXUjR6udkw3irC62UPCPniCNjrJVavSRnoqkkb5TckF93yQbce0QfA4093UMevPPT5EORAD1mGzK9zfYwHKfoonMzUjsnWEqOdAA75YE6m4A-xnQPie7iY1iQ0NHdFB8AaTcnH3YnZpmwpnYQMlIf6A_IsL6AXva99QlpmBOu9BD3gK_Ii95OCK-f6gX5_vnT3dV1cfPty9ery5vCVUrlgteNcx1zQvcNCCe3smsEyNbxqua1rRqrVFNZ2SgLutVK8NptNRNS86qTupIX5N0p95Dizxkwm2UjDqbJBogzGt60nFe6aldUnFCXImKC3hyS39t0NJyZVYsZzarFrFoMk2bRsjS9fcqft3vo_rb88bAAH04ALL988JAMOg_BQecTuGy66P-f__Gfdrf4885O93AEHOOcwrI_ww0Kw8ztehjrXfBaMsGYlr8Bsuy2Nw</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Pineles, Lisa, MA</creator><creator>Morgan, Daniel J., MD, MS</creator><creator>Lydecker, Alison, MPH</creator><creator>Johnson, J. Kristie, PhD</creator><creator>Sorkin, John D., MD, PhD</creator><creator>Langenberg, Patricia, PhD</creator><creator>Blanco, Natalia, PhD</creator><creator>Lesse, Alan, MD</creator><creator>Sellick, John, DO</creator><creator>Gupta, Kalpana, MD, MPH</creator><creator>Leykum, Luci, MD, MBA, MSc</creator><creator>Cadena, Jose, MD</creator><creator>Lepcha, Nickie, MD</creator><creator>Roghmann, Mary-Claire, MD, MS</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170901</creationdate><title>Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes</title><author>Pineles, Lisa, MA ; Morgan, Daniel J., MD, MS ; Lydecker, Alison, MPH ; Johnson, J. Kristie, PhD ; Sorkin, John D., MD, PhD ; Langenberg, Patricia, PhD ; Blanco, Natalia, PhD ; Lesse, Alan, MD ; Sellick, John, DO ; Gupta, Kalpana, MD, MPH ; Leykum, Luci, MD, MBA, MSc ; Cadena, Jose, MD ; Lepcha, Nickie, MD ; Roghmann, Mary-Claire, MD, MS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-178ccd0c26f8e2c3b3d82e39c14717a48a5584a385ae6965217cb6023614d3643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cross Infection</topic><topic>Female</topic><topic>Health Personnel - organization & administration</topic><topic>Humans</topic><topic>Infection Control</topic><topic>Infection Control - methods</topic><topic>Infectious Disease</topic><topic>Infectious Disease Transmission, Patient-to-Professional - prevention & control</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Methicillin-Resistant Staphylococcus aureus - pathogenicity</topic><topic>Methicillin-Resistant Staphylococcus aureus - physiology</topic><topic>Middle Aged</topic><topic>MRSA</topic><topic>Nursing home</topic><topic>Nursing Homes</topic><topic>Prospective Studies</topic><topic>Protective Clothing - microbiology</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Staphylococcal Infections - prevention & control</topic><topic>Staphylococcal Infections - transmission</topic><topic>Transmission</topic><topic>United States</topic><topic>Veterans</topic><topic>Workforce</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pineles, Lisa, MA</creatorcontrib><creatorcontrib>Morgan, Daniel J., MD, MS</creatorcontrib><creatorcontrib>Lydecker, Alison, MPH</creatorcontrib><creatorcontrib>Johnson, J. Kristie, PhD</creatorcontrib><creatorcontrib>Sorkin, John D., MD, PhD</creatorcontrib><creatorcontrib>Langenberg, Patricia, PhD</creatorcontrib><creatorcontrib>Blanco, Natalia, PhD</creatorcontrib><creatorcontrib>Lesse, Alan, MD</creatorcontrib><creatorcontrib>Sellick, John, DO</creatorcontrib><creatorcontrib>Gupta, Kalpana, MD, MPH</creatorcontrib><creatorcontrib>Leykum, Luci, MD, MBA, MSc</creatorcontrib><creatorcontrib>Cadena, Jose, MD</creatorcontrib><creatorcontrib>Lepcha, Nickie, MD</creatorcontrib><creatorcontrib>Roghmann, Mary-Claire, MD, MS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of infection control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pineles, Lisa, MA</au><au>Morgan, Daniel J., MD, MS</au><au>Lydecker, Alison, MPH</au><au>Johnson, J. Kristie, PhD</au><au>Sorkin, John D., MD, PhD</au><au>Langenberg, Patricia, PhD</au><au>Blanco, Natalia, PhD</au><au>Lesse, Alan, MD</au><au>Sellick, John, DO</au><au>Gupta, Kalpana, MD, MPH</au><au>Leykum, Luci, MD, MBA, MSc</au><au>Cadena, Jose, MD</au><au>Lepcha, Nickie, MD</au><au>Roghmann, Mary-Claire, MD, MS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes</atitle><jtitle>American journal of infection control</jtitle><addtitle>Am J Infect Control</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>45</volume><issue>9</issue><spage>947</spage><epage>953</epage><pages>947-953</pages><issn>0196-6553</issn><eissn>1527-3296</eissn><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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28431853</pmid><doi>10.1016/j.ajic.2017.03.004</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Cross Infection Female Health Personnel - organization & administration Humans Infection Control Infection Control - methods Infectious Disease Infectious Disease Transmission, Patient-to-Professional - prevention & control Intensive Care Units Male Methicillin-Resistant Staphylococcus aureus - pathogenicity Methicillin-Resistant Staphylococcus aureus - physiology Middle Aged MRSA Nursing home Nursing Homes Prospective Studies Protective Clothing - microbiology Staphylococcal Infections - microbiology Staphylococcal Infections - prevention & control Staphylococcal Infections - transmission Transmission United States Veterans Workforce |
| title | Transmission of methicillin-resistant Staphylococcus aureus to health care worker gowns and gloves during care of residents in Veterans Affairs nursing homes |
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