Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers.
OBJECTIVE
To assess the rate of and the risk factors for the detection of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) on the protective gowns and gloves of healthcare workers (HCWs).


METHODS
We observed the interactions between HCWs and patients during routine clinical activities in a 29-bed medical intensive care unit at the University of Maryland Medical Center, an urban tertiary care academic hospital. Samples for culture were obtained from HCWs' hands prior to their entering a patient's room, from HCWs' disposable gowns and gloves after they completed patient care activities, and from HCWs' hands immediately after they removed their protective gowns and gloves.


RESULTS
Of 137 HCWs caring for patients colonized or infected with MRSA and/or VRE, 24 (17.5%; 95% confidence interval, 11.6%-24.4%) acquired the organism on their gloves, gown, or both. HCW contact with the endotracheal tube or tracheostomy site of a patient (P < .05), HCW contact with the head and/or neck of a patient (P < .05), and HCW presence in the room of a patient with a percutaneous endoscopic gastrostomy and/or jejunostomy tube (P < .05) were associated with an increased risk of acquiring these organisms.


CONCLUSIONS
The gloves and gowns of HCWs frequently become contaminated with MRSA and VRE during the routine care of patients, and particularly during care of the patient's respiratory tract and any associated indwelling devices. As part of a larger infection control strategy, including high-compliance hand disinfection, they likely provide a useful barrier to transmitting antibiotic-resistant organisms among patients in an inpatient setting.
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Graham M
GM
Snyder
Kerri A
KA
Thom
Jon P
JP
Furuno
Eli N
EN
Perencevich
Mary-Claire
MC
Roghmann
Sandra M
SM
Strauss
Giora
G
Netzer
Anthony D
AD
Harris
D000046:Academic Medical Centers; D003428:Cross Infection / Q000517:prevention & control; D003470:Culture Media; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification*; D004866:Equipment Contamination; D017575:Gloves, Protective / Q000382:microbiology*; D006225:Hand / Q000382:microbiology; D006282:Health Personnel; D006801:Humans; D007362:Intensive Care Units; D008396:Maryland; D016106:Methicillin Resistance; D011481:Protective Clothing / Q000382:microbiology*; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D020713:Vancomycin Resistance
D003470:Culture Media