Clinical question: Does exposure to a patient with a multidrug-resistant organism result in colonization of a health care provider?
Background: Multidrug-resistant organisms (MDROs) are growing threats in our hospitals, particularly vancomycin-resistant enterococci (VRE) and resistant gram-negative bacteria. The role of the health care team in preventing infection transmission is paramount. If a team member who is caring for a patient with an MDRO or handling lab specimens becomes colonized with these bacteria, he or she could potentially transmit them to the next patient.
Dr. Suchita Shah Sata
Study design: Observational case control.
Setting: Large academic research hospital.
Synopsis: Staff submitted self-collected rectal swabs, which were then cultured for MDROs. 379 health care personnel (which they defined as having had self-reported exposure to MDROs) were compared with 376 staff members in the control group, who reported no exposure to MDROs. There was a nonsignificant difference between growth of multidrug-resistant organisms between the groups (4.0% vs 3.2%).
Bottom line: This study suggests that occupational exposure to an MDRO does not result in subsequent colonization of the health care provider and may not be a major risk factor for nosocomial transmission.
Citation: Decker BK et al. Healthcare personnel intestinal colonization with multidrug-resistant organisms. Clin Microbiol Infect. 2017 May 12. pii:S1198-743X(17)30270-7.
Dr. Sata is a medical instructor, Duke University Hospital.