Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-10T05:49:14.476Z Has data issue: false hasContentIssue false
  • English
  • Français

Effectiveness of barrier precautions for prevention of patient-to-patient transfer of a viral DNA surrogate marker

Published online by Cambridge University Press:  17 December 2020

Heba Alhmidi ,
Jennifer L. Cadnum ,
Yilen K. Ng-Wong ,
Annette L. Jencson ,
Brigid M. Wilson  and
Curtis J. Donskey
Heba Alhmidi
Affiliation:
Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
Jennifer L. Cadnum
Affiliation:
Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
Yilen K. Ng-Wong
Affiliation:
Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
Annette L. Jencson
Affiliation:
Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
Brigid M. Wilson
Affiliation:
Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
Curtis J. Donskey*
Affiliation:
Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio Case Western Reserve University School of Medicine, Cleveland, Ohio
*
Author for correspondence: Curtis J. Donskey, E-mail: Curtis. Donskey@va.gov
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Gloves and gowns are used during patient care to reduce contamination of personnel and prevent pathogen transmission.

Objective:

To determine whether the use of gowns adds a substantial benefit over gloves alone in preventing patient-to-patient transfer of a viral DNA surrogate marker.

Methods:

In total, 30 source patients had 1 cauliflower mosaic virus surrogate marker applied to their skin and clothing and a second to their bed rail and bedside table. Personnel caring for the source patients were randomized to wear gloves, gloves plus cover gowns, or no barrier. Interactions with up to 7 subsequent patients were observed, and the percentages of transfer of the DNA markers were compared among the 3 groups.

Results:

In comparison to the no-barrier group (57.8% transfer of 1 or both markers), there were significant reductions in transfer of the DNA markers in the gloves group (31.1% transfer; odds ratio [OR], 0.16; 95% confidence interval [CI], 0.02-0.73) and the gloves-plus-gown group (25.9% transfer; OR, 0.11; 95% CI, 0.01–0.51). The addition of a cover gown to gloves during the interaction with the source patient did not significantly reduce the transfer of the DNA marker (P = .53). During subsequent patient interactions, transfer of the DNA markers was significantly reduced if gloves plus gowns were worn and if hand hygiene was performed (P < .05).

Conclusions:

Wearing gloves or gloves plus gowns reduced the frequency of patient-to-patient transfer of a viral DNA surrogate marker. The use of gloves plus gowns during interactions with the source patient did not reduce transfer in comparison to gloves alone.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 9 , September 2021 , pp. 1031 - 1036
Check for updates
Creative Commons
This work is classified, for copyright purposes, as a work of the U.S. Government and is not subject to copyright protection within the United States
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

O’Hara, LM, Calfee, DP, Miller, LG, et al. Optimizing contact precautions to curb the spread of antibiotic-resistant bacteria in hospitals: a multicenter cohort study to identify patient characteristics and healthcare personnel interactions associated with transmission of methicillin-resistant Staphylococcus aureus . Clin Infect Dis 2019;69 suppl 3:S171–S177.CrossRefGoogle Scholar
Johnson, S, Gerding, DN, Olson, MM, et al. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med 1990;88:137–140.CrossRefGoogle ScholarPubMed
Tenorio, AR, Badri, SM, Sahgal, NB, et al. Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant Enterococcus species by healthcare workers after patient care. Clin Infect Dis 2001;32:826–829.CrossRefGoogle ScholarPubMed
Srinivasan, A, Song, X, Ross, T, Merz, W, Brower, R, Perl, TM. A prospective study to determine whether cover gowns in addition to gloves decrease nosocomial transmission of vancomycin resistant enterococci in an intensive care unit. Infect Control Hosp Epidemiol 2002;23:424–428.CrossRefGoogle Scholar
Puzniak, LA, Leet, T, Mayfield, J, Kollef, M, Mundy, LM. To gown or not to gown: the effect on acquisition of vancomycin-resistant enterococci. Clin Infect Dis 2002;35:18–25.CrossRefGoogle ScholarPubMed
Slaughter, S, Hayden, MK, Nathan, C, et al. A comparison of the effect of universal use of gloves and gowns with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit. Ann Intern Med 1996;125:448–456.CrossRefGoogle Scholar
Harris, AD, Pineles, L, Belton, B, et al. Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial. JAMA 2013;310:1571–1580.Google ScholarPubMed
Williams, C, McGraw, P, Schneck, EE, et al. Impact of universal gowning and gloving on health care worker clothing contamination. Infect Control Hosp Epidemiol 2015;36:431–437.CrossRefGoogle ScholarPubMed
Kanwar, A, Thakur, M, Wazzan, M, et al. Clothing and shoes of personnel as potential vectors for transfer of healthcare-associated pathogens to the community. Am J Infect Control 2019;47:577–579.CrossRefGoogle ScholarPubMed
Bearman, G, Bryant, K, Leekha, S, et al. Expert guidance: healthcare personnel attire in non–operating-room settings. Infect Control Hosp Epidemiol 2014;35:107–121.Google Scholar
Goyal, S, Khot, SC, Ramachandran, V, Shah, KP, Musher, DM. Bacterial contamination of medical providers’ white coats and surgical scrubs: a systematic review. Am J Infect Control 2019;47:994–1001.CrossRefGoogle ScholarPubMed
Oelberg, DG, Joyner, SE, Jiang, X, Laborde, D, Islam, MP, Pickering, LK. Detection of pathogen transmission in neonatal nurseries using DNA markers as surrogate indicators. Pediatrics 2000;105:311–315.CrossRefGoogle ScholarPubMed
John, A, Alhmidi, H, Cadnum, JL, Jencson, AL, Donskey, CJ. Contaminated portable equipment is a potential vector for dissemination of pathogens in the intensive care unit. Infect Control Hosp Epidemiol 2017;38:1247–1249.CrossRefGoogle ScholarPubMed
Alhmidi, H, Cadnum, JL, Jencson, AL, Gweder, AA, Donskey, CJ. Sharing is not always a good thing: use of a DNA marker to investigate the potential for ward-to-ward dissemination of healthcare-associated pathogens. Infect Control Hosp Epidemiol 2019;40:214–216.CrossRefGoogle Scholar
John, AR, Alhmidi, H, Gonzalez-Orta, MI, Cadnum, JL, Donskey, CJ. A randomized trial to determine whether wearing short-sleeved white coats reduces risk of pathogen transmission. Infect Control Hosp Epidemiol 2018;39:233–234.CrossRefGoogle ScholarPubMed
Alhmidi, H, John, A, Mana, TC, et al. Evaluation of viral surrogate markers for study of pathogen dissemination during simulations of patient care. Open Forum Infect Dis 2017;4:ofx128.CrossRefGoogle ScholarPubMed
Tomas, ME, Kundrapu, S, Thota, P, et al. Contamination of the skin and clothing of healthcare personnel during removal of personal protective equipment. JAMA Intern Med 2015;175:1904–1910.CrossRefGoogle ScholarPubMed
Krein, SL, Mayer, J, Harrod, M, et al. Identification and characterization of failures in infectious agent transmission precaution practices in hospitals: a qualitative study. JAMA Intern Med 2018;178:1016–1057.CrossRefGoogle ScholarPubMed
Vajravelu, RK, Guerrero, DM, Jury, LA, Donskey, CJ. Evaluation of stethoscopes as vectors of Clostridium difficile and methicillin-resistant Staphylococcus aureus . Infect Control Hosp Epidemiol 2012;33:96–98.CrossRefGoogle ScholarPubMed
Faulx, GR, Emig, EL, Alhmidi, H, et al. Efficacy of a wearable ultraviolet-C light device for semiautomated decontamination of stethoscopes between each use. Infect Control Hosp Epidemiol 2020;41:244–246.Google Scholar
Alhmidi, H, Li, DF, Cadnum, JL, et al. Use of simulations to evaluate the effectiveness of barrier precautions for prevention of patient to patient transfer of healthcare-associated pathogens. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.1215.CrossRefGoogle ScholarPubMed