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Detection of Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci on the Gowns and Gloves of Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Graham M. Snyder
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Kerri A. Thorn
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Jon P. Furuno
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Eli N. Perencevich
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland University of Maryland School of Medicine, and the Veterans Affairs Maryland Health Care System, Baltimore, Maryland
Mary-Claire Roghmann
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland University of Maryland School of Medicine, and the Veterans Affairs Maryland Health Care System, Baltimore, Maryland
Sandra M. Strauss
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland
Giora Netzer
Affiliation:
Internal Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland
Anthony D. Harris*
Affiliation:
Departments of Epidemiology and Preventive Medicine, Baltimore, Maryland University of Maryland School of Medicine, and the Veterans Affairs Maryland Health Care System, Baltimore, Maryland
*
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 100 N. Greene Street, Lower Level, Baltimore, MD 21201 (aharris@epi.umaryland.edu)

Abstract

Objective.

To assess the rate of and the risk factors for the detection of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) on the protective gowns and gloves of healthcare workers (HCWs).

Methods.

We observed the interactions between HCWs and patients during routine clinical activities in a 29-bed medical intensive care unit at the University of Maryland Medical Center, an urban tertiary care academic hospital. Samples for culture were obtained from HCWs' hands prior to their entering a patient's room, from HCWs' disposable gowns and gloves after they completed patient care activities, and from HCWs' hands immediately after they removed their protective gowns and gloves.

Results.

Of 137 HCWs caring for patients colonized or infected with MRSA and/or VRE, 24 (17.5%; 95% confidence interval, 11.6%–24.4%) acquired the organism on their gloves, gown, or both. HCW contact with the endotracheal tube or tracheostomy site of a patient (P < .05), HCW contact with the head and/or neck of a patient (P < .05), and HCW presence in the room of a patient with a percutaneous endoscopic gastrostomy and/or jejunostomy tube (P < .05) were associated with an increased risk of acquiring these organisms.

Conclusions.

The gloves and gowns of HCWs frequently become contaminated with MRSA and VRE during the routine care of patients, and particularly during care of the patient's respiratory tract and any associated indwelling devices. As part of a larger infection control strategy, including high-compliance hand disinfection, they likely provide a useful barrier to transmitting antibiotic-resistant organisms among patients in an inpatient setting.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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