Infection Control & Hospital Epidemiology


1427


Table 1. Demographic and Clinical Characteristics of Enrolled Residents of Community Nursing Facilities by Colonization Status as Detected on a Perianal Swab Enrolled Residents (n=399)a


Characteristics


Age, y, median (range) Gender Male


Female


Race/Ethnicity White


African American Hispanic Asians


Native Hawaiian/Other Pacific Islander Rehabilitation ADL score, median (range)


Recent acute-care hospitalization (3 mo) Devices


Indwelling urinary catheter External urinary catheter Ostomy


Feeding tube


Any wounds (any skin break) Antibiotics at enrollment


Secretions at enrollment Diarrhea


Stool incontinence


Heavy wound secretions Heavy respiratory secretions


Colonized with RGNB (n=74)


80 (47–98)


24 (32) 50 (68)


64 (86) 9 (12) 1 (1) 0 (0) 0 (0)


38 (51) 9 (0–16) 41 (55)


7 (10) 1 (1) 3 (4) 4 (5)


31 (42) 11 (15)


2 (3)


15 (20) 0 (0) 1 (1)


Note. RGNB, resistant Gram-negative bacteria, No. (%)/median (minimum–maximum). aEnrolled residents with a perianal swab collected.


Gown and glove transmission with RGNB by type of care


We observed a median of 7 interactions (interquartile range, 6–9) per RGNB colonized resident. Overall, either gowns or gloves were contaminated with RGNB during 11% of 584 interactions with RGNB colonized residents. Gloves were contaminated during 9% of 581 interactions (3 interactions were missing a glove specimen), and gowns were contaminated during 3% of 584 interactions. In addition, 73% of the inter- actions had only 1 type of care during the interaction; 11% had 2types of care;6%had 3types of care,and 10%had 4ormore types of care. The risk of RGNB transmission to gloves or gowns by type of care did not differ significantly when the type of care occurred alone or in conjunction with other types of care (data not shown).


RGNB transmission from colonized residents to HCP


varied by type of care activity from 0% to 22% for gowns and from 0% to 33% for gloves (Fig. 1). We identified showering, wound dressing change, diaper change, hygiene assistance (brushing teeth, combing hair), bathing, dressing, and trans- ferring the resident as high-risk activities for glove con- tamination (Table 2). Providing physical or occupational therapy, only giving medications, and glucose monitoring were considered low-risk activities for glove contamination (OR<1.0; P<.05; or no transmission observed). Showering, diaper change, toilet and hygiene assistance, bathing, dressing, and transferring the resident were identified as high-risk activities for gown contamination. Glucose monitoring, giving medications, and feeding were also identified as low-risk


Not Colonized with RGNB (n=325)


80 (39–102)


97 (30) 228 (70)


<.01


245 (76) 74 (23) 2 (1) 1 (0) 1 (0)


121 (37) 7 (0–16) 211 (65)


28 (9) 0 (0) 8 (2)


12 (4)


110 (34) 46 (14)


8 (2)


43 (13) 1 (0) 0 (0)


.03


<.01 .30


.80 .04 .45 .50 .20 .88


.91 .12 .81 .19


P Value .84 .66


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