Detection of Methicillin-ResistantStaphylococcus aureusand Vancomycin-Resistant Enterococci on the Gowns and Gloves of Healthcare Workers

Abstract

Objective-To assess the frequency of detection and risk factors for detection of methicillinresistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) by healthcare workers on infection control protective gown and gloves.Design-We observed interactions between healthcare workers and patients during routine clinical activities. Cultures were taken of healthcare workers' hands prior to entering the room, disposable infection control gown and gloves after completing patient care activities, and of hands immediately following removal of infection control protective gown and gloves.Setting-A 29-bed medical intensive care unit at an urban tertiary-care academic hospital, the University of Maryland Medical Center.Results-Seventeen percent (24/137, 95%CI ± 6.4%) of healthcare workers caring for a patient with MRSA and/or VRE acquired that organism on their gloves, gown or both. Contacting an endotracheal tube or tracheostomy (P < 0.05), contacting the head and/or neck of a patient (P < 0.05), and the presence of a percutaneous endoscopic gastrostomy/jejunostomy tube (P < 0.05) were associated with increased risk of detection of antibiotic-resistant organisms.Conclusions-Gloves and gowns are frequently contaminated with MRSA and VRE during routine care duties. Contact with the head or neck, care for an endotracheal tube or tracheostomy, and the presence of an endotracheal tube or tracheostomy may increase the risk of detection of antibiotic-resistant organisms.

Vestuário de profissionais de saúde como potenciais reservatórios de microrganismos: uma revisão integrativa

“…11,[16][17][18][19][21][22] Direct contact of the areas analyzed with the agar plates was used in two articles for obtaining the microbiological samples. 12,19 The bacterial species were identified by biochemical tests; and the antimicrobial susceptibility through the disc diffusion technique or by the identification of the Minimum Inhibitory Concentration (MIC).…”

“…12,19 The bacterial species were identified by biochemical tests; and the antimicrobial susceptibility through the disc diffusion technique or by the identification of the Minimum Inhibitory Concentration (MIC). [11][12][16][17][18][19][20][21][22] The pulsed field gel electrophoresis (PFGE) technique was used to verify the clonal relationship between the isolates, this being considered of broad application, as it enables the performance of genotyping and the comparison of similarity between microbial species. [22][23] Of the microbial samples isolated from the white coats, gowns and uniforms of the healthcare professionals, the following were identified: Diphtheroids, Vancomycin Resistant Enterococcus (VRE), gram-negative bacteria (Acinetobacter baumannii, Klebsiela pneumoniae and Serratia rubidae) and methicillin-resistant Staphylococcus aureus (MRSA), which was most frequently isolated, including in outbreak situations.…”

“…In the ICU a greater diversity of microorganisms resistant to penicillins, aminoglycosides and 1 st , 2 nd and 3 rd generation cephalosporins were recovered. [11][12][16][17][18][19][20][21][22] A higher level of contamination of clothing by VRE was observed during the care of patients with tracheostomy, gastrostomy, jejunostomy and ileostomy. 11,20 In two studies the results of molecular tests confirmed the similarity between the strains of the patient and those recovered from the clothing of the multiprofessional team.…”

“…[11][12][16][17][18][19][20][21][22] A higher level of contamination of clothing by VRE was observed during the care of patients with tracheostomy, gastrostomy, jejunostomy and ileostomy. 11,20 In two studies the results of molecular tests confirmed the similarity between the strains of the patient and those recovered from the clothing of the multiprofessional team. [21][22] Among the studies included in the integrative review, there was consensus that white coats, gowns or uniforms of the healthcare professionals can be contaminated during patient care, becoming potential vehicles for the dissemination of microorganisms associated with HAIs.…”

“…In this context, the clothing used in the quotidian of the healthcare professionals begins to be considered a potential reservoir for the transmission of microorganisms involved in the occurrence of HAI, even if in small proportions. [9][10][11][12] The spread of pathogens may occur in the hospital environment and also outside of this, i.e. in places in which the provision of direct care does not occur.…”