Open AccessMultidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?
Author(s) -
Lona Mody,
Laraine Washer,
Keith S. Kaye,
Kristen E. Gibson,
Sanjay Saint,
Katherine Reyes,
Marco Cassone,
Julia Mantey,
Jie Cao,
Sarah Altamimi,
Mary Beth Perri,
Hugo Sax,
Vineet Chopra,
Marcus Zervos
Publication year - 2019
Publication title -
clinical infectious diseases/clinical infectious diseases (online. university of chicago. press)
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.44
H-Index - 336
eISSN - 1537-6591
pISSN - 1058-4838
DOI - 10.1093/cid/ciz092
Subject(s) - medicine , hygiene , transmission (telecommunications) , infection control , contamination , pulsed field gel electrophoresis , methicillin resistant staphylococcus aureus , emergency medicine , staphylococcus aureus , surgery , pathology , ecology , biochemistry , chemistry , genetics , electrical engineering , gene , genotype , bacteria , engineering , biology
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.