Transfer of vancomycin-resistant enterococci via health care worker hands.

TLDR: Vancomycin-resistant enterococci were transferred from contaminated sites in the environment or on patients' intact skin to clean sites via HCW hands or gloves in 10.6% of opportunities.

Abstract: Background:Therolesofthecontaminatedhospitalenvironment and of patient skin carriage in the spread of vancomycin-resistant enterococci (VRE) are uncertain. Transfer of VRE via health care worker (HCW) hands is assumed but unproved. We sought to determine the frequency of VRE transmission from sites in the environment or on patients’ intact skin to clean environmental orskinsitesviacontaminatedhandsofHCWsduringroutine care. Methods:We cultured sites on the intact skin of 22 patients colonized by VRE, as well as sites in the patients’ rooms, before and after routine care by 98 HCWs. Observers recorded sites touched by HCWs. Cultures were obtained from HCW hands and/or gloves before and after care. All isolates underwent pulsed-field gel electrophoresis. We defined a transfer to have occurred when a culture-negative site became positive with a VRE pulsotype after being touched by an HCW who had the same pulsotypeonhisorherhandsorglovesandwhohadpre