Hand hygiene and superbugs

When new residents arrive at post-acute care (PAC) facilities, they may be bringing more with them than their discharge summaries. As recent discharge patients from hospitals, they also bring in multidrug-resistant organisms (MDROs) on their hands, such as Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and other superbugs, according to a research letter published in JAMA Internal Medicine.

Researchers studied arriving residents at six PAC facilities in Michigan, testing their dominant hands for microbes the day they arrived, on Day 14 and then once a month for up to six months. During the study, 357 residents were tested a total of 806 times.

The shocker: almost one-quarter of residents arrived at the PAC facility with at least one MDRO on their hands. Worse, the microbial presence spread after they moved in—follow-up tests showed increasing numbers of MDROs and new colonization of residents who had no MDROs earlier.

Although hand hygiene is a key part of infection control protocols among nurses and care teams, “patient hand-washing is not a routine practice in hospitals to date,” the research letter states. “Owing to PAC patients’ increased mobility and interaction with the environment, healthcare workers and other patients, we believe that it is even more important to implement routines that enforce washing of patients’ hands than in the acute care setting.”

Teaching residents to reduce their own risks with proper hand washing, especially after visiting the hospital or the PAC facility’s common spaces, could go a long way to curb the spread of drug-resistant infections, the researchers wrote. “[P]atient hand hygiene is a greatly underappreciated strategy for MDRO reduction efforts in PAC facilities.”

Topics: Clinical