Background: Barrier precautions (eg, gloves and gowns) are often used in clinical settings to reduce the risk for transmission of healthcare-associated pathogens. However, uncertainty persists regarding the efficacy of different types of barrier precautions in preventing transmission. Methods: We used simulated patient care interactions to compare the effectiveness of different levels of barrier precautions in reducing transfer of pathogen surrogate markers. Overall, 30 personnel performed standardized examinations of contaminated mannequins while wearing either no barriers, gloves, or gloves plus cover gowns followed by examination of a noncontaminated mannequin; the order of the barrier precautions was randomly assigned. Participants used their usual technique for hand hygiene, stethoscope cleaning, and protective equipment removal. The surrogate markers included cauliflower mosaic virus DNA, bacteriophage MS2, nontoxigenic Clostridium difficile spores, and a fluorescent tracer. We compared the frequency and route of transfer of each of the surrogate markers to the second mannequin or to the surrounding environment. Results: As shown in Fig. 1, wearing gloves alone or gloves plus gowns significantly reduced transfer of each of the surrogate markers by the hands of participants (P < .05 for each marker). However, wearing gloves or gloves plus gowns only modestly reduced transfer by stethoscopes despite cleaning of stethoscopes between exams by approximately half of the participants. Contamination of the clothing of participants was significantly reduced in the glove plus gown group versus the gloves only or no-barriers groups (P < .05). Conclusion: Barrier precautions are effective in reducing hand transfer of pathogens from patient to patient, but transfer may still occur via devices such as stethoscopes. Cover gowns reduce the risk for contamination of the clothing of personnel.

Funding: Proprietary Organization: The Center for Disease Control.

Disclosures: None