Pathogen Transmission Rife in Hospital Settings

Hospital rooms, not just the patients in them, can spread germs through contact with health care personnel, according to a new study.

Researchers at Duke University (Durham NC, USA) conducted a study to examine how pathogens cross the healthcare "transmission triangle": patients, the environment, and the health care provider. During the study, they took cultures from the sleeves, pockets, and midriffs of a new set of surgical scrubs of 40 intensive care unit (ICU) nurses, both at the start and end of each shift. Cultures were also collected from the bodies of all patients the nurse cared for during each shift, as well as and the patients' room contents (bed, bedrail, and supply cart).

In all, the researchers collected 2,185 cultures from the nurses' clothing, 455 from 167 patients, and 2,919 from the patients' rooms. Molecular analysis identified organisms on the nurses' clothing that were not present at the beginning of an ICU shift, but were present at the end. The researchers then looked for those same organisms in the samples collected from patients and their rooms, specifically searching for five pathogens known to cause difficult-to-treat infections, including Methicillin-resistant Staphylococcus aureus (MRSA).

During the shifts considered, the researchers confirmed 12 instances when at least one of the five pathogens was transmitted from the patient or the room to the scrubs. Six incidents each involved transmission from patient to nurse and room to nurse, and ten transmissions were from the patient to the room. The researchers did not document any nurse-to-patient or nurse-to-room transmission. The pockets and sleeves of the scrubs were most likely to be contaminated, as were the bed rails in the rooms. The study was presented at the annual IDWeek meeting, held during October 2016 in New Orleans (LA, USA).

“This study is a good wake-up call that health care personnel need to concentrate on the idea that the health care environment can be contaminated,” said lead author and study presenter Deverick Anderson, MD, of the Duke University School of Medicine. “Any type of patient care, or even just entry into a room where care is provided, truly should be considered a chance for interacting with organisms that can cause disease.”

“I think sometimes there's the misconception that if, for instance, a nurse is just talking to patients and not actually touching them, that it might be okay to skip protocols that help reduce pathogen transmission, like washing hands or wearing gloves,” concluded Dr. Anderson. “The study's results demonstrate the need for caution whenever health care providers enter a patient room, regardless of the task they're completing.”

Related Links:
Duke University