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MDR A. baumannii may often contaminate protective equipment of health care workers

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Almost 40% of protective gowns and gloves worn by health care workers who were exposed to patients with multidrug resistant Acinetobacter baumannii became contaminated during contact, according to findings presented at the 2009 meeting of the Society for Healthcare Epidemiology of America, held in San Diego.

Daniel Morgan, MD, of the University of Maryland Medical Center in Baltimore, presented the results. “A prior study using similar methods demonstrated that health care workers were contaminated by MRSA at a rate of about 18.5%, which is about half of the rate we observed for A. baumannii,” he said. “In our own study, we found that MDR A. baumannii was about four times as likely as Pseudomonas aeruginosa to contaminate health care workers.”

The study involved 202 health care workers who entered the rooms of patients with MDR A. baumannii and/or P. aeruginosa. A 39.5% (95% CI; 32.1-47.4%) transfer rate to the gloves and/or gown of health care workers occurred, and a 4.2% (95% CI; 1.7-8.5%) transfer rate to the hands of the workers after the removal of gloves and before hand washing occurred.

The rates for health care workers who had contact with P. aeruginosa patients were 8.3% (95% CI; 4.2-14.3%) for transfer to gloves or gowns and 0.8% (95% CI; 0.02-4.12%) for transfer to hands before washing.

“We also observed that contact with wounds, time of exposure and working with an endotracheal tube were independent risk factors for increased A. baumannii contamination,” Morgan said. – by Rob Volansky

For more information:

• Morgan D. #276. Presented at: Annual Meeting of the Society for Healthcare Epidemiology of America; March 19-22, 2009; San Diego.

This report describes the relatively high gown/glove contamination rates of health care workers with MDR A. baumannii vs. Pseudomonas aeruginosa. Colonization decreased after healthcare workers removed their gowns/gloves. Contamination of A. baumannii decreased from approximately 40% to 4.2%, whereas P. aeruginosa contamination decreased from 8.3% to 0.8%.

Not unexpectedly, the authors state that the likelihood of gown/glove contamination increased as a function of time. The take-home message from this report is that A. baumannii appears to have more of an ecological niche in the ICU than MRSA or P. aeruginosa. By implication, the study suggests that hand washing before and after degowning/degloving will further decrease A. baumannii contamination of protective apparel worn by health care workers.

– Burke A. Cunha, MD

Infectious Disease News Editorial Board member