October 6, 2013
Widespread Glove, Gown Use In ICUs Could Reduce Spread Of MRSA
redOrbit Staff & Wire Reports - Your Universe Online
The use of disposable gowns and gloves in all intensive care unit (ICU) patient rooms could reduce the spread of methicillin-resistant Staphylococcus aureus (MRSA) by roughly 40 percent, according to new research published Friday in the Journal of the American Medical Association (JAMA).Researchers from the University of Maryland School of Medicine and the Yale New Haven Health System Center for Healthcare Solutions reported in the study that the reduction in patient acquisition of MRSA was in comparison to medical professionals only using the protective gear in rooms on standard isolation protocol.
The research, which was funded by the Agency for Healthcare Research and Quality (AHRQ), did not demonstrate statistically significant results when it came to halting the spread of another disease-causing bacteria, vancomycin-resistant Enterococcus (VRE). However, the use of gowns and gloves increased hand washing frequency among healthcare workers and did not result in an increase in adverse effects for patients.
“We set out to find whether having healthcare workers wear gowns and gloves for all ICU patient contact could decrease the acquisition of antibiotic-resistant bacteria such as MRSA without causing any harm to the patient – and the answer was yes,” principal investigator Anthony D. Harris, a professor of epidemiology and public health at the University of Maryland School of Medicine, said in a statement.
“From a public health perspective, it's important that we evaluate interventions that may continue to drive these infection rates down, especially as concerns persist about antibiotic-resistant bacteria,” he added. The research was also presented during IDWeek 2013, an annual conference of over 5,500 professionals in the fields of healthcare epidemiology and infectious diseases.
Harris and his colleagues conducted a randomized trial in 20 medical and surgical ICUs in 20 different US hospitals from January through October of last year. In the intervention ICUs, all medical staff members were required to wear gloves and gowns any time they entered a patient’s room or came into contact with the patient.
They found that there was a decrease in both the intervention and control ICUs in terms of the composite MRSA and VRE acquisition rates over the study period, but the overall difference in change was not statistically significant. There was, however, a borderline statistically significant reduction in MRSA that was greater in the intervention group, according to the study authors.
“Based on the results of this study, it would be prudent for ICUs to consider adoption of universal gowning and gloving policies on intensive care units at highest risk for MRSA infections, regardless of whether patients have been positively cultured,” said co-author Beverly Belton, a PhD student at Yale University. “Concerns about healthcare personnel acceptance of and compliance with universal gowning and gloving can be overcome with creative efforts focused on early engagement and positive reinforcement.”
“Studies such as this continue to advance the knowledge and understanding of healthcare-associated infections and how they can be prevented. These results will certainly prove useful in evaluating public health policies and recommendations for how to best protect patients and advance their healing in the hospital setting,” added E. Albert Reece, vice president for medical affairs at the University of Maryland and Dean of the university’s School of Medicine.