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Universal gloving may offer small protective effect against HAIs
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Universal gloving may offer a small protective effect against health care-associated infections, or HAIs, and could be considered for implementation in high-risk settings, including pediatric ICUs, researchers reported in Infection Control & Hospital Epidemiology.
Contact precautions, including the use of nonsterile gloves during patient interaction, are recommended when patients are colonized or infected with multidrug-resistant organisms (MDROs), such as MRSA and vancomycin-resistant enterococci (VRE), noted Nai-Chung Nelson Chang, PhD, a postdoctoral research associate at the University of Utah School of Medicine, and colleagues
“Existing evidence on universal gloving is limited to specific pathogens, but the actual intervention is applicable to all pathogens that can be transmitted by hand contamination,” Chang told Infectious Disease News. “Therefore, despite a small observed protective effect, actual effect in practice may be greater.”
As a vertical intervention, contact precautions require the identification of MDRO colonization or infection before the protocols are implemented, Chang and colleagues wrote. However, they suggested that using universal gloving as a horizontal intervention — or the application of contact precautions to every patient encounter regardless of MDRO status — may “overcome barriers to effective use of contact precautions” and reduce MDRO transmission.
Chang and colleagues conducted a systematic literature review from September 2015 through July 2018, compiling eight studies about universal gloving and HAIs that met their search criteria. A stratified analysis demonstrated a nonsignificant association between universal gloving and MRSA (pooled incidence rate ratio [IRR] = 0.94; 95% CI, 0.79-1.11) and universal gloving and VRE (pooled IRR = 0.94; 95% CI, 0.69-1.28), the researchers reported.
They noted a significant association with decreased incidence of HAIs (IRR = 0.77; 95% CI, 0.67-0.89) in studies where universal gloving was implemented as a lone intervention. However, no significant association with HAI incidence (IRR = 0.95; 95% CI, 0.86–1.05) was observed for studies that implemented universal gloving as part of intervention bundles.
Chang and colleagues recommended further research to determine the effect universal gloving may have on a broader range of pathogens, such as gram-negative organisms.
“Universal gloving is effective for all pathogens that can be transmitted by hand contamination, given proper practices are used while putting gloves on,” Chang said. – by Marley Ghizzone
Disclosures: The authors report no relevant financial disclosures.
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