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Observational Study
. 2019 Nov 13;69(11):1837-1844.
doi: 10.1093/cid/ciz092.

Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

Lona Mody  1   2 , Laraine L Washer  3   4 , Keith S Kaye  4 , Kristen Gibson  1 , Sanjay Saint  5   6 , Katherine Reyes  7 , Marco Cassone  1 , Julia Mantey  1 , Jie Cao  1 , Sarah Altamimi  7 , Mary Perri  7 , Hugo Sax  8 , Vineet Chopra  5   6 , Marcus Zervos  7
Affiliations
Observational Study

Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

Lona Mody et al. Clin Infect Dis. .

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.

Keywords: acute care hospitals; colonization; contamination; multidrug-resistant organisms; new acquisition.

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Figures

Figure 1.
Figure 1.
Percentage of patient hand contamination and room surface contamination with multidrug-resistant organisms (MDROs). Patient hand contamination (left 3 columns) and patient room contamination (right 3 columns) were calculated at baseline, follow-up visits, and any time during follow-up. The table underneath indicates the raw numbers represented in the figure. *A patient can be colonized with 1 MDRO at baseline and be at risk to acquire another MDRO.
Figure 2.
Figure 2.
Multidrug-resistant organisms (MDROs) on patients and room surfaces by time in room prior to enrollment. Number of patients enrolled and cultured within 0–8 hours in the room, >8 to 16 hours in the room, and >16 to 24 hours in the room and proportion of patient and rooms colonized with MDROs.
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References

    1. Centers for Disease Control and Prevention. 2014 national and state healthcare-associated infections progress report. Available at: www.cdc.gov/hai/progress-report/index.html. Accessed 13 October 2017.
    1. Boyce JM, Pittet D; Healthcare Infection Control Practices Advisory Committee. Society for Healthcare Epidemiology of America. Association for Professionals in Infection Control. Infectious Diseases Society of America. Hand Hygiene Task Force Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA hand hygiene task force. Infect Control Hosp Epidemiol 2002; 23:S3–40. - PubMed
    1. Pittet D, Allegranzi B, Boyce J; World Health Organization World Alliance for Patient Safety First Global Patient Safety Challenge Core Group of Experts The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol 2009; 30:611–22. - PubMed
    1. Landers T, Abusalem S, Coty MB, Bingham J. Patient-centered hand hygiene: the next step in infection prevention. Am J Infect Control 2012; 40:S11–7. - PubMed
    1. Kim MK, Nam EY, Na SH, et al. . Discrepancy in perceptions regarding patient participation in hand hygiene between patients and health care workers. Am J Infect Control 2015; 43:510–5. - PubMed

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