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Infect Control Hosp Epidemiol. 2015 Sep;36(9):1050-7. doi: 10.1017/ice.2015.119. Epub 2015 May 26.

Transmission of Methicillin-Resistant Staphylococcus aureus (MRSA) to Healthcare Worker Gowns and Gloves During Care of Nursing Home Residents.

Author information

1
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
2
2Department of Pathology,University of Maryland School of Medicine,Baltimore,Maryland.
3
3Department of Medicine,University of Maryland School of Medicine,Baltimore,Maryland.
4
4Division of Geriatric and Palliative Care Medicine,University of Michigan Medical School,Ann Arbor,Michigan.

Abstract

OBJECTIVE:

To estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by healthcare workers (HCWs) interacting with nursing home residents to better inform infection prevention policies in this setting

DESIGN:

Observational study

SETTING:

Participants were recruited from 13 community-based nursing homes in Maryland and Michigan

PARTICIPANTS:

Residents and HCWs from these nursing homes

METHODS:

Residents were cultured for MRSA at the anterior nares and perianal or perineal skin. HCWs wore gowns and gloves during usual care activities. At the end of each activity, a research coordinator swabbed the HCW's gown and gloves.

RESULTS:

A total of 403 residents were enrolled; 113 were MRSA colonized. Glove contamination was higher than gown contamination (24% vs 14% of 954 interactions; P1.0; P<.05). We also identified low-risk care activities: giving medications and performing glucose monitoring (OR<1.0; P<.05). Residents with chronic skin breakdown had significantly higher rates of gown and glove contamination.

CONCLUSIONS:

MRSA transmission from MRSA-positive residents to HCW gown and gloves is substantial; high-contact activities of daily living confer the highest risk. These activities do not involve overt contact with body fluids, skin breakdown, or mucous membranes, which suggests the need to modify current standards of care involving the use of gowns and gloves in the nursing home setting.

PMID:
26008727
PMCID:
PMC4900177
DOI:
10.1017/ice.2015.119
[Indexed for MEDLINE]
Free PMC Article

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