Healthcare personnel intestinal colonization with multidrug-resistant organisms
B K Decker, A F Lau, J P Dekker, C D Spalding, N Sinaii, S Conlan, D K Henderson, J A Segre, K M Frank, T N Palmore, B K Decker, A F Lau, J P Dekker, C D Spalding, N Sinaii, S Conlan, D K Henderson, J A Segre, K M Frank, T N Palmore
Abstract
Objectives: This study aims to assess the association between patient contact and intestinal carriage of multidrug-resistant organisms (MDRO) by sampling healthcare personnel (HCP) and staff without patient contact.
Methods: For this observational study, we recruited 400 HCP who worked in our 200-bed research hospital and 400 individuals without patient contact between November 2013 and February 2015. Participants submitted two self-collected perirectal swabs and a questionnaire. Swabs were processed for multidrug-resistant Gram-negative bacteria and vancomycin-resistant enterococci (VRE). Questionnaires explored occupational and personal risk factors for MDRO carriage.
Results: Among 800 participants, 94.4% (755/800) submitted at least one swab, and 91.4% (731/800) also submitted questionnaires. Extended spectrum β-lactamase-producing organisms were recovered from 3.4% (26/755) of participants, and only one carbapenemase-producing organism was recovered. No VRE were detected. The potential exposure of 68.9% (250/363) of HCP who reported caring for MDRO-colonized patients did not result in a rate of MDRO carriage among HCP (4.0%; 15/379) significantly higher than that of staff without patient contact (3.2%; 12/376; p 0.55).
Conclusions: This is the largest US study of HCP intestinal MDRO carriage. The low colonization rate is probably reflective of local community background rates, suggesting that HCP intestinal colonization plays a minor role in nosocomial spread of MDROs in a non-outbreak setting.
Trial registration: clinicaltrials.gov Identifier: NCT01952158.
Keywords: Colonization; Healthcare personnel; Multidrug-resistant organism; Occupational exposure; Perirectal sampling.
Conflict of interest statement
Transparency declaration
All authors report no conflicts of interest. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Published by Elsevier Ltd.
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Source: PubMed