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Frequent Multidrug-Resistant Acinetobacter baumannii Contamination of Gloves, Gowns, and Hands of Healthcare Workers

  • Daniel J. Morgan (a1), Stephen Y. Liang (a2), Catherine L. Smith (a2), J. Kristie Johnson (a3), Anthony D. Harris (a1), Jon P. Furuno (a1), Kerri A. Thorn (a1), Graham M. Snyder (a2), Hannah R. Day (a1) and Eli N. Perencevich (a1)...

Multidrug-resistant (MDR) gram-negative bacilli are important nosocomial pathogens.


To determine the incidence of transmission of MDR Acinetobacter baumannii and Pseudomonas aeruginosa from patients to healthcare workers (HCWs) during routine patient care.


Prospective cohort study.


Medical and surgical intensive care units.


We observed HCWs who entered the rooms of patients colonized with MDR A. baumannii or colonized with both MDR A. baumannii and MDR P. aeruginosa. We examined their hands before room entry, their disposable gloves and/or gowns upon completion of patient care, and their hands after removal of gloves and/or gowns and before hand hygiene.


Sixty-five interactions occurred with patients colonized with MDR A. baumannii and 134 with patients colonized with both MDR A. baumannii and MDR P. aeruginosa. Of 199 interactions between HCWs and patients colonized with MDR A. baumannii, 77 (38.7% [95% confidence interval {CI}, 31.9%–45.5%]) resulted in HCW contamination of gloves and/or gowns, and 9 (4.5% [95% CI, 1.6%–7.4%]) resulted in contamination of HCW hands after glove removal before hand hygiene. Of 134 interactions with patients colonized with MDR P. aeruginosa, 11 (8.2% [95% CI, 3.6%–12.9%]) resulted in HCW contamination of gloves and/or gowns, and 1 resulted in HCW contamination of hands. Independent risk factors for contamination with MDR A. baumannii were manipulation of wound dressing (adjusted odds ratio [aQR], 25.9 [95% CI, 3.1–208.8]), manipulation of artificial airway (aOR, 2.1 [95% CI, 1.1–4.0]), time in room longer than 5 minutes (aOR, 4.3 [95% CI, 2.0–9.1]), being a physician or nurse practitioner (aOR, 7.4 [95% CI, 1.6–35.2]), and being a nurse (aOR, 2.3 [95% CI, 1.1–4.8]).


Gowns, gloves, and unwashed hands of HCWs were frequently contaminated with MDR A. baumannii. MDR A. baumannii appears to be more easily transmitted than MDR P. aeruginosa and perhaps more easily transmitted than previously studied methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus. This ease of transmission may help explain the emergence of MDR A. baumannii.

Corresponding author
Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, 685 West Baltimore Street, MSTF 334D, Baltimore, MD 21201 (
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1.Peleg, AY, Seifert, H, Paterson, DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008;21:538582.
2.Gaynes, R, Edwards, JR; National Nosocomial Infections Surveillance System. Overview of nosocomial infections caused by gram-negative bacilli. Clin Infect Dis 2005;41:848854.
3.Boucher, HW, Talbot, GH, Bradley, JS, et al. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis 2009;48:112.
4.Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L; Health Care Infection Control Practices Advisory Committee. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 2007;35:S65S164.
5.Harbarth, S, Fankhauser, C, Schrenzel, J, et al. Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 2008;299:11491157.
6.Robicsek, A, Beaumont, JL, Paule, SM, et al. Universal surveillance for methicillin-resistant Staphylococcus aureus in 3 affiliated hospitals. Ann Intern Med 2008;148:409418.
7.Barbolla, RE, Centron, D, Maimone, S, et al. Molecular epidemiology of Acinetobacter baumannii spread in an adult intensive care unit under an endemic setting. Am J Infect Control 2008;36:444452.
8.Gbaguidi-Haore, H, Legast, S, Thouverez, M, Bertrand, X, Talon, D. Ecological study of the effectiveness of isolation precautions in the management of hospitalized patients colonized or infected with Acinetobacter baumannii. Infect Control Hosp Epidemiol 2008;29:11181123.
9.Olsen, R, Lynch, P, Coyle, M, Cummings, J, Bokete, T, Stamm, W. Examination gloves as barriers to hand contamination in clinical practice. JAMA 1993;270:350353.
10.Snyder, GM, Thom, KA, Furuno, JP, et al. Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers. Infect Control Hosp Epidemiol 2008;29:583589.
11.Centers for Disease Control and Prevention. Protocols CDC PulseNet. May 13,2009. Accessed May 5, 2010.
12.Ecker, JA, Massire, C, Hall, TA, et al. Identification of Acinetobacter species and genotyping of Acinetobacter baumannii by multilocus PCR and mass spectrometry. J Clin Microbiol 2006;44:2921.
13.Tenover, F, Arbeit, R, Goering, R, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:22332239.
14.Evans, HL, Shaffer, MM, Hughes, MG, et al. Contact isolation in surgical patients: a barrier to care? Surgery 2003;134:180188.
15.Chai, LYA, Ng, TM, Habib, AG, Singh, K, Kumarasinghe, G, Tambyah, PA. Paradoxical increase in methicillin-resistant Staphylococcus aureus acquisition rates despite barrier precautions and increased hand washing compliance during an outbreak of severe acute respiratory syndrome. Clin Infect Dis 2005;40:632633.
16.Stelfox, HT, Bates, DW, Redelmeier, DA. Safety of patients isolated for infection control. JAMA 2003;290:18991905.
17.Furuno, JP, Hebden, JN, Standiford, HC, et al. Prevalence of methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii in a long-term acute care facility. Am J Infect Control 2008;36:468471.
18.Pittet, D, Hugonnet, S, Harbarth, S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356: 13071312.
19.Hayden, MK, Blom, DW, Lyle, EA, Moore, CG, Weinstein, RA. Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant Enterococcus or the colonized patients' environment. Infect Control Hosp Epidemiol 2008;29:149154.
20.Boyce, JM, Potter-Bynoe, G, Chenevert, C, King, T. Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications. Infect Control Hosp Epidemiol 1997; 18: 622627.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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