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- Title
Comparison of Routine Glove Use and Contact-Isolation Precautions to Prevent Transmission of Multidrug-Resistant Bacteria in a Long-Term Care Facility.
- Authors
Trick, William E.; Weinstein, Robert A.; DeMarais, Patricia L.; Tomaska, Wanda; Nathan, Catherine; McAllister, Sigrid K.; Hageman, Jeffrey C.; Rice, Thomas W.; Westbrook, Glennis; Jarvis, William R.
- Abstract
To compare routine glove use by healthcare workers for all residents, without use of contact-isolation precautions, with contact-isolation precautions for the care of residents who had vancomycin-resistant enterococci or methicillin-resistantStaphylococcus aureusisolated from a clinical cultureRandom allocation of two similar sections of the skilled-care unit to one of the infection-control strategies during an 18-month study period.Skilled-care unit of a 667-bed acute- and long-term care facility.All residents present or admitted to the skilled-care unit from June 1, 1998, through December 7, 1999.Resident acquisition of four antimicrobial-resistant organisms (methicillin-resistantStaphylococcus aureus, vancomycin-resistant enterococci, or extended-spectrumβ-lactamase-producingKlebsiella pneumoniaeorEscherichia coli). All isolates were strain typed. The facility level costs associated with each strategy were estimated.Resident acquisition of antimicrobial-resistant organisms was no different in the glove-use and isolation-precautions sections (31 episodes (1.5 per 1,000 resident-days) vs 38 episodes (1.6 per 1,000 resident-days)). Acquisition of either of two prevalentK. pneumoniaestrains was more likely (P=.06) in residents in the isolation-precautions section. The estimated costs of contact-isolation precautions were 40% greater than those of routine glove use.There was a similar frequency of transmission of antimicrobial-resistant bacteria in the two study sections; there was evidence for resident-to-residentK. pneumoniaetransmission in the isolation-precautions section. Routine glove use for healthcare workers, which decreases resident social isolation and healthcare facility costs, may be preferable in many long-term care facilities.
- Subjects
LONG-term care facilities; MULTIDRUG resistance; STAPHYLOCOCCUS aureus; MEDICAL personnel; VANCOMYCIN; PENICILLIN
- Publication
Journal of the American Geriatrics Society, 2004, Vol 52, Issue 12, p2003
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/j.1532-5415.2004.52555.x