Kyle J Gontjes1,2, Kristen E Gibson1, Bonnie Lansing1, Marco Cassone1, Lona Mody1,3. 1. Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, Michigan. 2. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan. 3. Geriatrics Research, Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
Abstract
OBJECTIVES: To quantify the multidrug-resistant organism (MDRO) burden of high-touch common area and rehabilitation gym surfaces, and to assess microorganism transfer potential during rehabilitation sessions. DESIGN: Prospective study of environmental contamination. SETTING: Nursing home (NH). PARTICIPANTS: Six Michigan NHs. MEASUREMENTS: Monthly samples from common area surfaces (eg, living room), rehabilitation equipment, and rehabilitation personnel hands were screened for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and resistant gram-negative bacilli (R-GNB). To assess microorganism transfer potential, we conducted an in-depth assessment of microorganism transfer during 10 rehabilitation sessions. Microorganism transfer was defined as the identification of a microorganism on a destination surface that was uncontaminated before the rehabilitation session. Patient frequency of common area usage was also assessed qualitatively. RESULTS: We obtained 1338 common area specimens from 180 monthly facility visits, of which 13.4% (179/1338) were MDRO positive: MRSA, 3.8%; VRE, 5.8%; and R-GNB, 5.1%. A total of 64% (116/180) of sampling visits had at least one MDRO-positive common area specimen. Within rehabilitation gyms, we obtained 521 equipment and 190 personnel hand specimens during 60 monthly visits. Of the equipment specimens collected, 7.7% (40/521) were MDRO positive: MRSA, 2.5%; VRE, 4.0%; and R-GNB, 1.9%. Of the 190 rehabilitation personnel hand specimens collected, 3.7% (7/190) were MDRO positive. Overall, 55% (33/60) of rehabilitation gym visits had at least one MDRO-positive specimen. Microorganism transfer assessment during 10 rehabilitation sessions revealed 35 opportunities for transfer during which microorganism transfer occurred in 17.1% (6/35) of opportunities. CONCLUSION: NH common areas and rehabilitation gyms are MDRO reservoirs that may contribute to the transmission of healthcare-associated pathogens. Because NHs accommodate the increasing short-stay patient population, developing effective interventions that reduce MDRO transmission in the common area and rehabilitation gym environment should be considered an infection prevention priority. J Am Geriatr Soc 68:478-485, 2020.
OBJECTIVES: To quantify the multidrug-resistant organism (MDRO) burden of high-touch common area and rehabilitation gym surfaces, and to assess microorganism transfer potential during rehabilitation sessions. DESIGN: Prospective study of environmental contamination. SETTING: Nursing home (NH). PARTICIPANTS: Six Michigan NHs. MEASUREMENTS: Monthly samples from common area surfaces (eg, living room), rehabilitation equipment, and rehabilitation personnel hands were screened for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and resistant gram-negative bacilli (R-GNB). To assess microorganism transfer potential, we conducted an in-depth assessment of microorganism transfer during 10 rehabilitation sessions. Microorganism transfer was defined as the identification of a microorganism on a destination surface that was uncontaminated before the rehabilitation session. Patient frequency of common area usage was also assessed qualitatively. RESULTS: We obtained 1338 common area specimens from 180 monthly facility visits, of which 13.4% (179/1338) were MDRO positive: MRSA, 3.8%; VRE, 5.8%; and R-GNB, 5.1%. A total of 64% (116/180) of sampling visits had at least one MDRO-positive common area specimen. Within rehabilitation gyms, we obtained 521 equipment and 190 personnel hand specimens during 60 monthly visits. Of the equipment specimens collected, 7.7% (40/521) were MDRO positive: MRSA, 2.5%; VRE, 4.0%; and R-GNB, 1.9%. Of the 190 rehabilitation personnel hand specimens collected, 3.7% (7/190) were MDRO positive. Overall, 55% (33/60) of rehabilitation gym visits had at least one MDRO-positive specimen. Microorganism transfer assessment during 10 rehabilitation sessions revealed 35 opportunities for transfer during which microorganism transfer occurred in 17.1% (6/35) of opportunities. CONCLUSION: NH common areas and rehabilitation gyms are MDRO reservoirs that may contribute to the transmission of healthcare-associated pathogens. Because NHs accommodate the increasing short-stay patient population, developing effective interventions that reduce MDRO transmission in the common area and rehabilitation gym environment should be considered an infection prevention priority. J Am Geriatr Soc 68:478-485, 2020.
Authors: Robert E Burke; Elizabeth Juarez-Colunga; Cari Levy; Allan V Prochazka; Eric A Coleman; Adit A Ginde Journal: JAMA Intern Med Date: 2015-02 Impact factor: 21.873
Authors: Lisa Pineles; Eli N Perencevich; Mary-Claire Roghmann; Kalpana Gupta; Jose Cadena; Gio Baracco; Christopher D Pfeiffer; Graeme Forrest; Suzanne F Bradley; Chris Crnich; Heather S Reisinger; Daniel J Morgan Journal: Infect Control Hosp Epidemiol Date: 2019-05-20 Impact factor: 3.254
Authors: Marco Cassone; Julia Mantey; Mary Beth Perri; Kristen Gibson; Bonnie Lansing; Sara McNamara; Payal K Patel; Vincent C C Cheng; Maroya S Walters; Nimalie D Stone; Marcus J Zervos; Lona Mody Journal: Clin Infect Dis Date: 2018-08-31 Impact factor: 9.079
Authors: Charlene C Quinn; Cynthia L Port; Sheryl Zimmerman; Ann L Gruber-Baldini; Judith D Kasper; Irene Fleshner; Barbara Yody; John Loome; Jay Magaziner Journal: J Am Geriatr Soc Date: 2008-08-04 Impact factor: 5.562
Authors: Kyle J Gontjes; Kristen E Gibson; Bonnie J Lansing; Julia Mantey; Karen M Jones; Marco Cassone; Joyce Wang; John P Mills; Lona Mody; Payal K Patel Journal: JAMA Netw Open Date: 2022-02-01
Authors: Lona Mody; Kyle J Gontjes; Marco Cassone; Kristen E Gibson; Bonnie J Lansing; Julia Mantey; Mohammed Kabeto; Andrzej Galecki; Lillian Min Journal: JAMA Netw Open Date: 2021-07-01