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

Abstract

BackgroundThe 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.MethodsPatients 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.ResultsA 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.ConclusionsOur 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.

Contamination of Common Area and Rehabilitation Gym Environment with Multidrug‐Resistant Organisms

“…Because patient hand contamination with MDROs is higher than healthcare provider hand contamination with MDROs, these findings point to the role of patient hands in MDRO transmission. Furthermore, patient hands are markedly easy to culture, implicated as vehicles of transmission, and they are therefore more likely to be informative when considering patient mobility outside of their rooms . Our assessment of microorganism transfer potential provides evidence of patient seeding of environmental surfaces and subsequent acquisition potential for both patients and healthcare providers.…”

“…Furthermore, patient hands are markedly easy to culture, implicated as vehicles of transmission, and they are therefore more likely to be informative when considering patient mobility outside of their rooms. 19,34 Our assessment of microorganism transfer potential provides evidence of patient seeding of environmental surfaces and subsequent acquisition potential for both patients and healthcare providers. These results further support the growing evidence of the transfer of microorganisms between patients, healthcare providers, and their environment during the provision of patient care.…”

“…As reservoirs, environmental fomites have an increasingly evident role in direct and indirect transmission of nosocomial pathogens . For example, we recently demonstrated that contamination of the patient room environment correlates with patient colonization in both acute and post‐acute care settings …”

“…[14][15][16] For example, we recently demonstrated that contamination of the patient room environment correlates with patient colonization in both acute and post-acute care settings. [17][18][19] A growing body of evidence has focused on the contribution of the proximal patient room environment, 18,[20][21][22] medical equipment, 23 and nursing-associated surfaces [24][25][26] to the persistence and transmission of MDROs in both acute and post-acute care settings. However, little is known about the contamination of high-touch surfaces in common areas.…”

Bacteriophages for Chronic Wound Treatment: From Traditional to Novel Delivery Systems

“…This opportunistic pathogen causes infections, mainly in the elderly and immunocompromised individuals [32,33]. Wound contamination can also occur through cross-infection events, such as poor hand hygiene practiced by healthcare clinicians after wound cleansing and dressing procedures, coughing and sneezing, dirty bedding, unsterilized medical equipment, and prolonged use of catheters, tubes, or intravenous lines [34][35][36][37][38]. Wound contaminants can also derive from the environment.…”