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- Title
Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?
- Authors
Mody, Lona; Washer, Laraine L; Kaye, Keith S; Gibson, Kristen; Saint, Sanjay; Reyes, Katherine; Cassone, Marco; Mantey, Julia; Cao, Jie; Altamimi, Sarah; Perri, Mary; Sax, Hugo; Chopra, Vineet; Zervos, Marcus
- Abstract
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.
- Subjects
MICHIGAN; BACTERIOPHAGE typing; CROSS infection; ELECTROPHORESIS; HAND; HEALTH facilities; HOSPITAL patients; HOSPITAL admission &; discharge; HOSPITAL emergency services; HOST-bacteria relationships; HYGIENE; LONGITUDINAL method; MEDICAL appointments; MEDICAL protocols; MULTIDRUG resistance; PATIENTS; PUBLIC health surveillance; RISK assessment; ROOMS; DISCHARGE planning; METHICILLIN-resistant staphylococcus aureus
- Publication
Clinical Infectious Diseases, 2019, Vol 69, Issue 11, p1837
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciz092