Presented in part at the Fourth Decennial International Conference on Nosocomial and Healthcare-Associated Infections, March 2000. Abstract S-M2-03.
Comparison of Routine Glove Use and Contact-Isolation Precautions to Prevent Transmission of Multidrug-Resistant Bacteria in a Long-Term Care Facility
Article first published online: 18 NOV 2004
Journal of the American Geriatrics Society
Volume 52, Issue 12, pages 2003–2009, December 2004
How to Cite
Trick, W. E., Weinstein, R. A., DeMarais, P. L., Tomaska, W., Nathan, C., McAllister, S. K., Hageman, J. C., Rice, T. W., Westbrook, G. and Jarvis, W. R. (2004), Comparison of Routine Glove Use and Contact-Isolation Precautions to Prevent Transmission of Multidrug-Resistant Bacteria in a Long-Term Care Facility. Journal of the American Geriatrics Society, 52: 2003–2009. doi: 10.1111/j.1532-5415.2004.52555.x
- Issue published online: 18 NOV 2004
- Article first published online: 18 NOV 2004
- nursing homes;
- patient isolation;
- extended spectrum beta-lactamases;
- vancomycin-resistant enterococci;
- methicillin-resistant Staphylococcus aureus
Objectives: To compare routine glove use by healthcare workers for all residents, without use of contact-isolation precautions, with contact-isolation precautions for the care of residents who had vancomycin-resistant enterococci or methicillin-resistant Staphylococcus aureus isolated from a clinical culture
Design: Random allocation of two similar sections of the skilled-care unit to one of the infection-control strategies during an 18-month study period.
Setting: Skilled-care unit of a 667-bed acute- and long-term care facility.
Participants: All residents present or admitted to the skilled-care unit from June 1, 1998, through December 7, 1999.
Measurements: Resident acquisition of four antimicrobial-resistant organisms (methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, or extended-spectrum β-lactamase-producing Klebsiella pneumoniae or Escherichia coli). All isolates were strain typed. The facility level costs associated with each strategy were estimated.
Results: Resident acquisition of antimicrobial-resistant organisms was no different in the glove-use and isolation-precautions sections (31 episodes (1.5 per 1,000 resident-days) vs 38 episodes (1.6 per 1,000 resident-days)). Acquisition of either of two prevalent K. pneumoniae strains was more likely (P=.06) in residents in the isolation-precautions section. The estimated costs of contact-isolation precautions were 40% greater than those of routine glove use.
Conclusion: There was a similar frequency of transmission of antimicrobial-resistant bacteria in the two study sections; there was evidence for resident-to-resident K. pneumoniae transmission in the isolation-precautions section. Routine glove use for healthcare workers, which decreases resident social isolation and healthcare facility costs, may be preferable in many long-term care facilities.