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Recovery of Vancomycin-Resistant Enterococci on Fingertips and Environmental Surfaces

Published online by Cambridge University Press:  02 January 2015

Gary A. Noskin
Affiliation:
Division of Infectious Diseases, Department of Medicine, Northwestern University Medical School, Chicago, Illinois Clinical Microbiology Section, Department of Pathology, Northwestern University Medical School, Chicago, Illinois
Valentina Stosor
Affiliation:
Division of Infectious Diseases, Department of Medicine, Northwestern University Medical School, Chicago, Illinois
Isabell Cooper
Affiliation:
Clinical Microbiology Laboratory, Northwestern Memorial Hospital, Chicago, Illinois
Lance R. Peterson
Affiliation:
Division of Infectious Diseases, Department of Medicine, Northwestern University Medical School, Chicago, Illinois Clinical Microbiology Section, Department of Pathology, Northwestern University Medical School, Chicago, Illinois

Abstract

Objective:

To determine the recovery of vancomycin-resistant enterococci (VRE) on fingertips, gloved fingertips, and environmental surfaces commonly encountered in the healthcare setting, and to examine the importance of handwashing on the removal of these organisms.

Design:

Two clinical isolates of VRE (Enterococcus faecalis and Enterococcus faecium) were inoculated onto the hands of healthy human volunteers and the following environmental surfaces: countertops, bedrails, telephones, and stethoscopes. Following inoculation, samples were obtained at various time intervals to determine rates of recovery of organisms. To evaluate the effects of handwashing on enterococcal recovery, two different soap preparations were tested. Hands were washed with water alone or with one of the soaps and water. The soap and water studies were performed with a 5-second and a 30-second wash.

Results:

Both enterococcal strains survived for at least 60 minutes on gloved and ungloved fingertips. The E faecalis was recoverable from countertops for 5 days; the E faecium persisted for 7 days. For bedrails, both enterococcal species survived for 24 hours without significant reduction in colony counts. The bacteria persisted for 60 minutes on the telephone handpiece and for 30 minutes on the diaphragmatic surface of the stethoscope. A 5-second wash with water alone resulted in virtually no change in recovery of enterococci; a 30-second wash with water plus either soap was necessary to eradicate the bacteria from hands completely.

Conclusion:

VRE are capable of prolonged survival on hands, gloves, and environmental surfaces. Hands should be washed thoroughly and gloves removed following contact with patients infected or colonized with these multidrug-resistant bacteria. Finally, environmental surfaces may serve as potential reservoirs for nosocomial transmission of VRE and need to be considered when formulating institutional infection control policies.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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