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Research Letter |

Multidrug-Resistant Organisms on Patients’ Hands A Missed Opportunity

Jie Cao, MPH1; Lillian Min, MD, MPH2,3; Bonnie Lansing, LPN3; Betsy Foxman, PhD4; Lona Mody, MD, MSc2,3
[+] Author Affiliations
1Department of Pathology, University of Michigan Medical School, Ann Arbor
2Veterans Affairs Healthcare System, Geriatric Research, Education, and Clinical Center, Ann Arbor, Michigan
3Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor
4School of Public Health, University of Michigan, Ann Arbor
JAMA Intern Med. 2016;176(5):705-706. doi:10.1001/jamainternmed.2016.0142.
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Baseline, new acquisition, and duration of hand carriage of multidrug-resistant organisms among patients newly admitted to post–acute care facilities from acute care hospitals is evaluated.

Multidrug-resistant organisms (MDROs) are increasingly prevalent in post–acute care (PAC) facilities.1,2 Increased contact between health care workers, the environment, and patients in PAC facilities can increase the risk of MDRO cross-transmission3,4 because PAC patients may need assistance with activities of daily living and are encouraged to be mobile outside of their room for rehabilitation, dining, and other recreational activities. Much more than other anatomic sites, patients’ hands are more likely to come in contact with environmental surfaces, health care workers’ hands, and other patients in PAC facilities. Our objective was to evaluate baseline, new acquisition, and duration of MDRO hand carriage among patients newly admitted to PAC facilities from acute care hospitals.

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Patient Hand Carriage of Organisms at Baseline and Follow-up

MDRO indicates multidrug resistant organism; MRSA, methicillin-resistant Staphylococcus aureus; RGNB, resistant-gram negative bacilli; and VRE, vancomycin-resistant Enterococcus. During the entire follow-up period, 34.2% (122 of 357) patients were colonized by at least 1 MDRO. MRSA, VRE, and RGNB were colonized on patients hands at rates of 16.5% (59 of 357), 19.9% (71 of 357), and 5.9% (21 of 357), respectively.

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