Bacterial burden is associated with increased transmission to health care workers from patients colonized with vancomycin-resistant Enterococcus
JournalAmerican Journal of Infection Control
MetadataShow full item record
AbstractBackground: Health care workers (HCWs) are significant vectors for transmission of multidrug-resistant organisms among patients in intensive care units (ICUs). We studied ICU patients on contact precautions, colonized with vancomycin-resistant Enterococcus (VRE), to assess whether bacterial burden is associated with transmission to HCWs’ gloves or gowns, a surrogate outcome for transmission to subsequent patients. Methods: From this prospective cohort study, we analyzed 96 VRE-colonized ICU patients and 5 HCWs per patient. We obtained samples from patients’ perianal area, skin, and stool to assess bacterial burden and cultured HCWs’ gloves and gowns for VRE after patient care. Results: Seventy-one of 479 (15%) HCW-patient interactions led to contamination of HCWs’ gloves or gowns with VRE. HCW contamination was associated with VRE burden on the perianal swab (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.19, 1.57), skin swabs (OR, 2.14; 95% CI, 1.51, 3.02), and in stool (OR, 1.95; 95% CI, 1.39, 2.72). Compared with colonization with Enterococcus faecalis, colonization with Enterococcus faecium was associated with higher bacterial burden and higher odds of transmission to HCWs. Conclusions: We show that ICU patients with higher bacterial burden are more likely to transmit VRE to HCWs. These findings have implications for VRE decolonization and other infection control interventions. Copyright 2019 Association for Professionals in Infection Control and Epidemiology, Inc.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85053877873&doi=10.1016%2fj.ajic.2018.07.011&partnerID=40&md5=5317cbf5d83564cb579269f79901eb5a; http://hdl.handle.net/10713/10560
- Patient contact is the main risk factor for vancomycin-resistant Enterococcus contamination of healthcare workers' gloves and gowns in the intensive care unit.
- Authors: Jackson SS, Thom KA, Magder LS, Stafford KA, Johnson JK, Miller LG, Calfee DP, Harris AD, CDC Prevention Epicenters Program.
- Issue date: 2018 Sep
- Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant enterococcus or the colonized patients' environment.
- Authors: Hayden MK, Blom DW, Lyle EA, Moore CG, Weinstein RA
- Issue date: 2008 Feb
- Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers.
- Authors: Snyder GM, Thom KA, Furuno JP, Perencevich EN, Roghmann MC, Strauss SM, Netzer G, Harris AD
- Issue date: 2008 Jul
- Detection of vancomycin resistance in enterococcus species isolated from clinical samples and feces of colonized patients by phenotypic and genotypic methods.
- Authors: Biswas PP, Dey S, Adhikari L, Sen A
- Issue date: 2016 Apr-Jun
- Identification of subclinical transmission of vancomycin-resistant enterococcus within an intensive care unit in Taiwan.
- Authors: Lee SC, Lee CW, Shih TC, See LC, Chu CM, Liu YC
- Issue date: 2016 Oct