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Recovery of Vancomycin-Resistant Enterococci on Fingertips and Environmental Surfaces

Published online by Cambridge University Press:  02 January 2015

Gary A. Noskin ,
Valentina Stosor ,
Isabell Cooper  and
Lance R. Peterson
Gary A. Noskin
Affiliation:
Division of Infectious Diseases, Department of Medicine, Northwestern University Medical School, Chicago, Illinois Clinical Microbiology Section, Department of Pathology, Northwestern University Medical School, Chicago, Illinois
Valentina Stosor
Affiliation:
Division of Infectious Diseases, Department of Medicine, Northwestern University Medical School, Chicago, Illinois
Isabell Cooper
Affiliation:
Clinical Microbiology Laboratory, Northwestern Memorial Hospital, Chicago, Illinois
Lance R. Peterson
Affiliation:
Division of Infectious Diseases, Department of Medicine, Northwestern University Medical School, Chicago, Illinois Clinical Microbiology Section, Department of Pathology, Northwestern University Medical School, Chicago, Illinois
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Abstract

Objective:

To determine the recovery of vancomycin-resistant enterococci (VRE) on fingertips, gloved fingertips, and environmental surfaces commonly encountered in the healthcare setting, and to examine the importance of handwashing on the removal of these organisms.

Design:

Two clinical isolates of VRE (Enterococcus faecalis and Enterococcus faecium) were inoculated onto the hands of healthy human volunteers and the following environmental surfaces: countertops, bedrails, telephones, and stethoscopes. Following inoculation, samples were obtained at various time intervals to determine rates of recovery of organisms. To evaluate the effects of handwashing on enterococcal recovery, two different soap preparations were tested. Hands were washed with water alone or with one of the soaps and water. The soap and water studies were performed with a 5-second and a 30-second wash.

Results:

Both enterococcal strains survived for at least 60 minutes on gloved and ungloved fingertips. The E faecalis was recoverable from countertops for 5 days; the E faecium persisted for 7 days. For bedrails, both enterococcal species survived for 24 hours without significant reduction in colony counts. The bacteria persisted for 60 minutes on the telephone handpiece and for 30 minutes on the diaphragmatic surface of the stethoscope. A 5-second wash with water alone resulted in virtually no change in recovery of enterococci; a 30-second wash with water plus either soap was necessary to eradicate the bacteria from hands completely.

Conclusion:

VRE are capable of prolonged survival on hands, gloves, and environmental surfaces. Hands should be washed thoroughly and gloves removed following contact with patients infected or colonized with these multidrug-resistant bacteria. Finally, environmental surfaces may serve as potential reservoirs for nosocomial transmission of VRE and need to be considered when formulating institutional infection control policies.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 10 , October 1995 , pp. 577 - 581
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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References

1. Schaberg, DR, Culver, DH, Gaynes, RP. Major trends in microbial etiology of nosocomial infections. Am J Med 1991;91(suppl 3B):72S–75S.CrossRefGoogle Scholar
2. Centers for Disease Control. Nosocomial enterococci resistant to vancomycin—United States, 1989-1993. MMWR 1993;42:597–599.Google Scholar
3. Uttley, AHC, Collins, CH, Naidoo, J, George, RC. Vancomycin-resistant enterococci [letter]. Lancet 1988;1:57–58.CrossRefGoogle ScholarPubMed
4. Karanfil, LV, Murphy, M, Josephson, A, et al. A cluster of vancomycin-resistant Enterococcus faecium in an intensive care unit. Infect Control Hosp Epidemiol 1992;13:195–200.Google Scholar
5. Green, M, Barbadora, K, Michaels, M. Recovery of vancomycin-resistant gram-positive cocci from pediatric liver transplant recipients. J Clin Microbiol 1991;29:2503–2506.CrossRefGoogle ScholarPubMed
6. Livoernese, LL Jr, Dias, S, Samel, C, et al. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med 1992;117:112–116.Google Scholar
7. Boyce, JM, Opal, SM, Chow, JW, et al. Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol 1994;32:1148–1153.CrossRefGoogle ScholarPubMed
8. Olsen, RJ, Lynch, P, Coyle, MB, Cummings, J, Bokete, T, Stamm, WE. Examination gloves as barriers to hand contamination in clinical practice. JAMA 1993;270:350–353.CrossRefGoogle ScholarPubMed
9. Johnson, S, Gerding, DN, Olson, MM, et al. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficle nosocomial transmission. Am J Med 1990;88:137–140.CrossRefGoogle Scholar
10. Hospital Infection Control Practices Advisory Committee (HICPAC). Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 1995;16:105–113.CrossRefGoogle Scholar
11. Wells, VD, Wong, ES, Murray, BE, Coudron, PE, Williams, DS, Markowitz, SM. Infections due to beta-lactamase-producing, high-level gentamicin-resistant Enterococcus faecalis . Ann Intern Med 1992;116:285–292.Google Scholar
12. Wade, JJ, Desai, N, Casewell, MW. Hygienic hand disinfection for the removal of epidemic vancomycin-resistant Enterococcus faecium and gentamicin-resistant Enterobacter cloacae . J Hosp Infect 1991;18:211–218.CrossRefGoogle ScholarPubMed
13. Arroyo, JC, Harrison, K, Birgenheier, R. The stethoscope—a vector of infection? [letter] Infect Control 1983;4:189.CrossRefGoogle ScholarPubMed
14. Casewell, MW, Desai, N. Survival of multiply-resistant Klebsiella aerogenes and other gram-negative bacteria on finger-tips. J Hosp Infect 1983;4:350–360.Google Scholar
15. Musa, EK, Desai, N, Casewell, MW. The survival of Acinetobacter calcocaceticus inoculated on fingertips and on formica. J Hosp Infect 1990;15:219–227.CrossRefGoogle ScholarPubMed
16. Buxton, AE, Anderson, RL, Werdegar, D, Atlas, E. Nosocomial respiratory tract infection and colonization with Acinetobacter calcoaceticus. Epidemiologic characteristics. Am J Med 1978;65:507–513.Google Scholar
17. Fujita, K, Lilly, HA, Ayliffe, GAJ. Spread of resistant gram-negative bacilli in burns unit. J Hosp Infect 1982;3:29–37.Google Scholar
18. Getchell-White, SI, Donowitz, LG, Gröschel, DHM. The inanimate environment of an intensive care unit as a potential source of nosocomial bacteria: evidence for long survival of Acinetobacter calcoaceticus . Infect Control Hosp Epidemiol 1989;10:402–407.Google Scholar
19. Steere, A, Mallison, GF. Hand-washing practices for the prevention of nosocomial infections. Ann Intern Med 1975;83:683–690.CrossRefGoogle Scholar