title: Transmission of Methicillin-Resistant Staphylococcus aureus (MRSA) to Healthcare Worker Gowns and Gloves During Care of Nursing Home Residents.
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
  
  
  METHODS
  Observational study
  
  
  METHODS
  Participants were recruited from 13 community-based nursing homes in Maryland and Michigan
  
  
  METHODS
  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.
authors.affiliation: 1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: Mary-Claire
authors.initials: MC
authors.lastname: Roghmann
authors.affiliation: 2Department of Pathology,University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: J Kristie
authors.initials: JK
authors.lastname: Johnson
authors.affiliation: 3Department of Medicine,University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: John D
authors.initials: JD
authors.lastname: Sorkin
authors.affiliation: 1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Langenberg
authors.affiliation: 1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: Alison
authors.initials: A
authors.lastname: Lydecker
authors.affiliation: 1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: Brian
authors.initials: B
authors.lastname: Sorace
authors.affiliation: 1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: Lauren
authors.initials: L
authors.lastname: Levy
authors.affiliation: 4Division of Geriatric and Palliative Care Medicine,University of Michigan Medical School,Ann Arbor,Michigan.
authors.forename: Lona
authors.initials: L
authors.lastname: Mody
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D050456:Fomites / Q000382:microbiology*; D005932:Gloves, Surgical / Q000382:microbiology; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D009732:Nursing Care; D009735:Nursing Homes; D009740:Nursing Staff; D011446:Prospective Studies; D011481:Protective Clothing / Q000382:microbiology*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology / Q000635:transmission*