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Risk of Hand or Glove Contamination After Contact With Patients Colonized With Vancomycin-Resistant Enterococcus or the Colonized Patients' Environment

Published online by Cambridge University Press:  02 January 2015

Mary K. Hayden ,
Donald W. Blom ,
Elizabeth A. Lyle ,
Charity G. Moore  and
Robert A. Weinstein
Mary K. Hayden*
Affiliation:
Rush University Medical Center, Chicago, Illinois
Donald W. Blom
Affiliation:
Rush University Medical Center, Chicago, Illinois
Elizabeth A. Lyle
Affiliation:
Rush University Medical Center, Chicago, Illinois
Charity G. Moore
Affiliation:
University of North Carolina, Chapel Hill
Robert A. Weinstein
Affiliation:
Rush University Medical Center, Chicago, Illinois John H. Stroger (Cook County) Hospital, Chicago, Illinois
*
Rush University Medical Center, 1653 W. Congress Pkwy., Chicago, IL 60612 ([email protected])
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Abstract

Objective.

To estimate the level of hand or glove contamination with vancomycin-resistant enterococci (VRE) among healthcare workers (HCWs) who touch a patient colonized with VRE and/or the colonized patient's environment during routine care.

Design.

Structured observational study.

Setting.

Medical intensive care unit of a 700-bed, tertiary-care teaching hospital.

Participants.

VRE-colonized patients and their caregivers.

Methods.

We obtained samples from sites on the intact skin of 22 patients colonized with VRE and samples from sites in the patients' rooms, before and after routine care, during 27 monitoring episodes. A total of 98 unique HCWs were observed during 131 HCW observations. Observers recorded the sites touched by HCWs. Culture samples were obtained from HCWs' hands and gloves before and after care.

Results.

VRE were isolated from a mean (±SD) of 55% ± 24% of patient sites (n = 256) and 17% ± 12% of environmental sites (n = 1,572). Most HCWs (131 [56%]) touched both the patient and the patient's environment; no HCW touched only the patient. Of 103 HCWs whose hand samples were negative for VRE when they entered the room, 52% contaminated their hands or gloves after touching the environment, and 70% contaminated their hands or gloves after touching the patient and the environment (P = .101). In a univariate logistic regression model, the risk of hand or glove contamination was associated with the number of contacts made (odds ratio, 1.1 [95% confidence interval, 1.01-1.19). In a multivariate model, the effect of the number of contacts could not be distinguished from the effect of type of contact (ie, touching the environment alone or touching both the patient and the environment). Overall, 37% of HCWs who did not wear gloves contaminated their hands, and 5% of HCWs who wore gloves did so (an 86% difference).

Conclusion.

HCWs were nearly as likely to have contaminated their hands or gloves after touching the environment in a room occupied by a patient colonized by VRE as after touching the colonized patient and the patient's environment. Gloves were highly protective with respect to hand contamination.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 2 , February 2008 , pp. 149 - 154
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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