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Contamination of Gowns, Gloves, and Stethoscopes With Vancomycin-Resistant Enterococci

Published online by Cambridge University Press:  02 January 2015

Kimon C. Zachary ,
Pamela S. Bayne ,
Victoria J. Morrison ,
Dale S. Ford ,
Leah Christine Silver  and
David C. Hooper
Kimon C. Zachary
Affiliation:
Infectious Disease Division, Massachusetts General Hospital, Boston, Massachusetts Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
Pamela S. Bayne
Affiliation:
Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
Victoria J. Morrison
Affiliation:
Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
Dale S. Ford
Affiliation:
Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
Leah Christine Silver
Affiliation:
Infectious Disease Division, Massachusetts General Hospital, Boston, Massachusetts
David C. Hooper*
Affiliation:
Infectious Disease Division, Massachusetts General Hospital, Boston, Massachusetts Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
*
Infectious Disease Division, Department of Medicine, Massachusetts General Hospital, 55 Fruit St, GRJ504, Boston, MA 02114-2696
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Abstract

Objective:

To measure directly the rate of contamination, during routine patient examination, of gowns, gloves, and stethoscopes with vancomycin-resistant enterococci (VRE).

Setting:

A large, academic, tertiary-care hospital.

Patients:

Between January 1997 and December 1998, 49 patients colonized or infected with VRE were entered in the study.

Design:

After routine examination, the examiner's glove fingertips, gown (the umbilical region and the cuffs), and stethoscope diaphragm were pressed onto Columbia colistin-nalidixic acid (CNA) agar plates with 5% sheep blood plus vancomycin 6 ug/mL. The stethoscope diaphragm was sampled again after cleaning with a 70% isopropanol wipe.

Results:

VRE were isolated from at least 1 examiner site (gloves, gowns, or stethoscope) in 33 (67%) of 49 cases. Gloves were contaminated in 63%, gowns in 37%, and stethoscopes in 31%. All three items were positive for VRE in 24%. One case each had stethoscope and gown contamination without glove contamination. Only 1 (2%) of 49 stethoscopes was positive after wiping with an alcohol swab. Contamination at any site was more likely when the patient had a colostomy or ileostomy. Patients identified by rectal-swab culture alone were as likely to contaminate their examiners as were those identified by clinical specimens.

Conclusions:

Our study revealed a high rate of examiner contamination with VRE. The similar risk of contamination identified by surveillance and clinical cases reinforces concerns that patients not known to be colonized with VRE could serve as sources for dissemination. Wiping with alcohol is effective in decontaminating stethoscopes.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 9 , September 2001 , pp. 560 - 564
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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