Researchers have found that wearing gloves and gowns in intensive care units does not reduce overall rates of acquiring MRSA or VRE, a study published online by JAMA has revealed.
Bacteria methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) are the primary causes of health care-associated infections. And these, as the study notes, are the most common complication of hospital care, affecting an estimated 5% of inpatients.
The study also records that the cost of antibiotic-resistance in the US is estimated at more than $4 billion per year.
The Centers for Disease Control and Prevention (CDC) estimate that 1 in 3 people carry the Staphylococcus bacteria in their noses, usually without any ill-effects.
However, two in 100 people carry the antibiotic-resistant strain – MRSA. In health care settings, MRSA infections are more serious and potentially life-threatening, as the bacteria can enter the bloodstream through surgical sites.
The CDC recommends wearing gloves and gowns when caring for patients infected with antibiotic-resistant bacteria. However, as infection with MRSA, VRE, or other antibiotic-resistant bacteria is often not detected, these precautions may not be applied.
It has not been known whether wearing gloves and gowns for all patient contact – not just for patients with known infections – decreases acquisition of antibiotic-resistant bacteria in the intensive care unit (ICU).
Dr. Anthony D. Harris, of the University of Maryland School of Medicine, Baltimore, and colleagues set out to test this with a randomized trial. The trial was conducted in 20 medical and surgical ICUs in 20 US hospitals from January 2012 to October 2012.
Swabs were collected from 26,180 ICU patients on both admission and discharge from both the intervention and control ICUs. Cultures were grown from the 92,241 swabs collected to check for infection of MRSA or VRE.
In the intervention ICUs, all health care workers were required to wear gloves and gowns for all patient contact and when entering any patient room.
The researchers found that there was a decrease in both the intervention and control ICUs in the composite rate of MRSA or VRE acquisition over the study periods, but the difference in change was not statistically significant.
There was a borderline statistically significant reduction in MRSA that was greater in the intervention group.
The intervention did not reduce VRE acquisition, but it did reduce MRSA acquisition, although the authors noted that there was better hand hygiene compliance on room exit in the intervention ICUs.
Good hygiene is vital for preventing MRSA infection. Simple measures, such as using antibacterial soap and ointment can be extremely effective.
It is also worth noting that a CDC study has shown that