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ABSTRACT: Objective
To determine which healthcare worker (HCW) roles and patient care activities are associated with acquisition of vancomycin-resistant Enterococcus (VRE) on HCW gloves or gowns after patient care, as a surrogate for transmission to other patients.Design
Prospective cohort study.Setting
Medical and surgical intensive care units at a tertiary-care academic institution.ParticipantsVRE-colonized patients on Contact Precautions and their HCWs.Methods
Overall, 94 VRE-colonized patients and 469 HCW-patient interactions were observed. Research staff recorded patient care activities and cultured HCW gloves and gowns for VRE before doffing and exiting patient room.Results
VRE were isolated from 71 of 469 HCWs' gloves or gowns (15%) following patient care. Occupational/physical therapists, patient care technicians, nurses, and physicians were more likely than environmental services workers and other HCWs to have contaminated gloves or gowns. Compared to touching the environment alone, the odds ratio (OR) for VRE contamination associated with touching both the patient (or objects in the immediate vicinity of the patient) and environment was 2.78 (95% confidence interval [CI], 0.99-0.77) and the OR associated with touching only the patient (or objects in the immediate vicinity) was 3.65 (95% CI, 1.17-11.41). Independent risk factors for transmission of VRE to HCWs were touching the patient's skin (OR, 2.18; 95% CI, 1.15-4.13) and transferring the patient into or out of bed (OR, 2.66; 95% CI, 1.15-6.43).Conclusion
Patient contact is a major risk factor for HCW contamination and subsequent transmission. Interventions should prioritize contact precautions and hand hygiene for HCWs whose activities involve touching the patient.
SUBMITTER: Jackson SS
PROVIDER: S-EPMC6442931 | biostudies-literature | 2018 Sep
REPOSITORIES: biostudies-literature
Jackson Sarah S SS Thom Kerri A KA Magder Laurence S LS Stafford Kristen A KA Johnson J Kristie JK Miller Loren G LG Calfee David P DP Harris Anthony D AD
Infection control and hospital epidemiology 20180727 9
<h4>Objective</h4>To determine which healthcare worker (HCW) roles and patient care activities are associated with acquisition of vancomycin-resistant Enterococcus (VRE) on HCW gloves or gowns after patient care, as a surrogate for transmission to other patients.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Medical and surgical intensive care units at a tertiary-care academic institution.ParticipantsVRE-colonized patients on Contact Precautions and their HCWs.<h4>Methods</h4>Overall, 9 ...[more]