Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

Authors:
Lona Mody
Lona Mody
University of Michigan Medical School
United States
Laraine L Washer
Laraine L Washer
University of Michigan Health System
Ann Arbor | United States
Keith S Kaye
Keith S Kaye
Wayne State University
United States
Kristen Gibson
Kristen Gibson
University of Arkansas
Sanjay Saint
Sanjay Saint
University of Michigan Medical School
Ann Arbor | United States
Katherine Reyes
Katherine Reyes
Wayne State University School of Medicine
United States
Marco Cassone
Marco Cassone
Temple University
United States
Julia Mantey
Julia Mantey
University of Michigan Medical School

Clin Infect Dis 2019 Apr 13. Epub 2019 Apr 13.

Division of Infectious Diseases, Henry Ford Health System, Detroit, Michigan.

Background: The impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role of patient hand contamination needs to be characterized further.

Methods: Patients from 2 hospitals in southeast Michigan were recruited within 24 hours of arrival to their room and followed prospectively using microbial surveillance of nares, dominant hand, and 6 high-touch environmental surfaces. Sampling was performed on admission, days 3 and 7, and weekly until discharge. Paired samples of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the patients' hand and room surfaces were evaluated for relatedness using pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec, and Panton-Valentine leukocidin typing.

Results: A total of 399 patients (mean age, 60.8 years; 49% male) were enrolled and followed for 710 visits. Fourteen percent (n = 56/399) of patients were colonized with an MDRO at baseline; 10% (40/399) had an MDRO on their hands. Twenty-nine percent of rooms harbored an MDRO. Six percent (14/225 patients with at least 2 visits) newly acquired an MDRO on their hands during their stay. New MDRO acquisition in patients occurred at a rate of 24.6/1000 patient-days, and in rooms at a rate of 58.6/1000 patient-days. Typing demonstrated a high correlation between MRSA on patient hands and room surfaces.

Conclusions: Our data suggest that patient hand contamination with MDROs is common and correlates with contamination on high-touch room surfaces. Patient hand hygiene protocols should be considered to reduce transmission of pathogens and healthcare-associated infections.

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Source
https://academic.oup.com/cid/advance-article/doi/10.1093/cid
Publisher Site
http://dx.doi.org/10.1093/cid/ciz092DOI Listing
April 2019
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References

(Supplied by CrossRef)

Centers for Disease Control and Prevention et al.

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