OBJECTIVE: Medical procedures and patient care activities may facilitate environmental dissemination of healthcare-associated pathogens such as methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Observational cohort study of MRSA-colonized patients to determine the frequency of and risk factors for environmental shedding of MRSA during procedures and care activities in carriers with positive nares and/or wound cultures. Bivariate analyses were performed to identify factors associated with environmental shedding. SETTING: A Veterans Affairs hospital. PARTICIPANTS: This study included 75 patients in contact precautions for MRSA colonization or infection. RESULTS: Of 75 patients in contact precautions for MRSA, 55 (73%) had MRSA in nares and/or wounds and 25 (33%) had positive skin cultures. For the 52 patients with MRSA in nares and/or wounds and at least 1 observed procedure, environmental shedding of MRSA occurred more frequently during procedures and care activities than in the absence of a procedure (59 of 138, 43% vs 8 of 83, 10%; P 0.9 m from the patient (52 of 138, 38% vs 25 of 138, 18%; P = .0004). Contamination occurred frequently on surfaces touched by personnel (12 of 38, 32%) and on portable equipment used for procedures (25 of 101, 25%). By bivariate analysis, the presence of a wound with MRSA was associated with shedding (17 of 29, 59% versus 6 of 23, 26%; P = .04). CONCLUSIONS: Environmental shedding of MRSA occurs frequently during medical procedures and patient care activities. There is a need for effective strategies to disinfect surfaces and equipment after procedures.
OBJECTIVE: Medical procedures and patient care activities may facilitate environmental dissemination of healthcare-associated pathogens such as methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Observational cohort study of MRSA-colonized patients to determine the frequency of and risk factors for environmental shedding of MRSA during procedures and care activities in carriers with positive nares and/or wound cultures. Bivariate analyses were performed to identify factors associated with environmental shedding. SETTING: A Veterans Affairs hospital. PARTICIPANTS: This study included 75 patients in contact precautions for MRSA colonization or infection. RESULTS: Of 75 patients in contact precautions for MRSA, 55 (73%) had MRSA in nares and/or wounds and 25 (33%) had positive skin cultures. For the 52 patients with MRSA in nares and/or wounds and at least 1 observed procedure, environmental shedding of MRSA occurred more frequently during procedures and care activities than in the absence of a procedure (59 of 138, 43% vs 8 of 83, 10%; P 0.9 m from the patient (52 of 138, 38% vs 25 of 138, 18%; P = .0004). Contamination occurred frequently on surfaces touched by personnel (12 of 38, 32%) and on portable equipment used for procedures (25 of 101, 25%). By bivariate analysis, the presence of a wound with MRSA was associated with shedding (17 of 29, 59% versus 6 of 23, 26%; P = .04). CONCLUSIONS: Environmental shedding of MRSA occurs frequently during medical procedures and patient care activities. There is a need for effective strategies to disinfect surfaces and equipment after procedures.
Authors: Julie Ann Martel; Piyali Chatterjee; John David Coppin; Marjory Williams; Hosoon Choi; Mark Stibich; Sarah Simmons; Deborah Passey; Chetan Jinadatha Journal: Am J Infect Control Date: 2021-10 Impact factor: 4.303
Authors: Aline Wolfensberger; Nora Mang; Kristen E Gibson; Lona Mody; Hugo Sax; Kyle Gontjes; Marco Cassone; Silvio D Brugger Journal: Infect Control Hosp Epidemiol Date: 2021-08-27 Impact factor: 6.520
Authors: Jessica Kumar; Brandon Eilertson; Jennifer L Cadnum; Chauna S Whitlow; Annette L Jencson; Nasia Safdar; Sarah L Krein; Windy D Tanner; JeanMarie Mayer; Matthew H Samore; Curtis J Donskey Journal: Pathog Immun Date: 2019-10-28
Authors: Sarah N Redmond; Jennifer L Cadnum; Sandra Y Silva; Basya S Pearlmutter; Annette L Jencson; Heba Alhmidi; Brigid M Wilson; Curtis J Donskey Journal: Infect Control Hosp Epidemiol Date: 2021-05-26 Impact factor: 3.254