The hands of newly admitted patients are commonly contaminated with multidrug-resistant organisms, or MDROs, including MRSA, leading to contamination of high-touch room surfaces, such as call buttons and tray tables, according to study findings.
“For more than a century, hand hygiene research, resources, and promotion have almost exclusively focused on improving [health care provider (HCP)] hand hygiene. These efforts have included efficient, safer, and more effective cleansing products, innovative educational delivery models, materials, and training, as well as auditing strategies,” Lona Mody, MD, MSc, professor of internal medicine at the University of Michigan Medical School and associate director of clinical programs at the VA Ann Arbor Geriatric Research and Education Clinical Center, and colleagues wrote.
“With contemporary patients allotting substantial time toward interactions and procedures inside and outside their rooms, pathogen transfer between the environment and patient hands is likely and yet understudied.”
In a prospective cohort study, Mody and colleagues tested the hands and nares of patients from two southeast Michigan hospitals as well as six high-touch environmental surfaces in their rooms, including bed controls, call buttons, and bedside tray tables. According to the study, sampling was performed on admission, at days 3 and 7, and weekly until the patient was discharged.
In total, 399 patients were enrolled and followed for 710 visits. According to study data, 14% of patients were colonized with an MDRO at baseline, 10% had an MDRO on their hands — including more than half who tested positive for MRSA — 29% of rooms were contaminated by an MDRO within 24 hours of admission, and 6% of patients tested during at least two visits newly acquired an MDRO on their hands during their stay.
Overall, Mody and colleagues reported that new MDRO acquisition in patients occurred at a rate of 24.6 per 1,000 patient-days and in rooms at a rate of 58.6 per 1,000 patient-days. They found a strong correlation between MRSA on patient hands and room surfaces, and reported that “patient hand contamination was associated with patient room contamination with the same MDRO.”
“While the burden of preventing infections has largely been borne by HCPs, our study shows that patient hands are an important reservoir and play a crucial role in the transmission of pathogens in acute-care hospitals,” the authors concluded. “Thus, patient hand hygiene protocols should be implemented and tested for their ability to reduce environmental contamination, pathogen transmission, and health care-associated infections as well as to increase meaningful patient engagement in infection prevention.” – by Caitlyn Stulpin
Disclosures: Mody reports receiving grants from the NIH outside the submitted work. Please see the study for all other authors’ relevant financial disclosures.