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Risk of Hand or Glove Contamination After Contact With Patients Colonized With Vancomycin-Resistant Enterococcus or the Colonized Patients' Environment

  • Mary K. Hayden (a1), Donald W. Blom (a1), Elizabeth A. Lyle (a1), Charity G. Moore (a2) and Robert A. Weinstein (a1) (a3)...

To estimate the level of hand or glove contamination with vancomycin-resistant enterococci (VRE) among healthcare workers (HCWs) who touch a patient colonized with VRE and/or the colonized patient's environment during routine care.


Structured observational study.


Medical intensive care unit of a 700-bed, tertiary-care teaching hospital.


VRE-colonized patients and their caregivers.


We obtained samples from sites on the intact skin of 22 patients colonized with VRE and samples from sites in the patients' rooms, before and after routine care, during 27 monitoring episodes. A total of 98 unique HCWs were observed during 131 HCW observations. Observers recorded the sites touched by HCWs. Culture samples were obtained from HCWs' hands and gloves before and after care.


VRE were isolated from a mean (±SD) of 55% ± 24% of patient sites (n = 256) and 17% ± 12% of environmental sites (n = 1,572). Most HCWs (131 [56%]) touched both the patient and the patient's environment; no HCW touched only the patient. Of 103 HCWs whose hand samples were negative for VRE when they entered the room, 52% contaminated their hands or gloves after touching the environment, and 70% contaminated their hands or gloves after touching the patient and the environment (P = .101). In a univariate logistic regression model, the risk of hand or glove contamination was associated with the number of contacts made (odds ratio, 1.1 [95% confidence interval, 1.01-1.19). In a multivariate model, the effect of the number of contacts could not be distinguished from the effect of type of contact (ie, touching the environment alone or touching both the patient and the environment). Overall, 37% of HCWs who did not wear gloves contaminated their hands, and 5% of HCWs who wore gloves did so (an 86% difference).


HCWs were nearly as likely to have contaminated their hands or gloves after touching the environment in a room occupied by a patient colonized by VRE as after touching the colonized patient and the patient's environment. Gloves were highly protective with respect to hand contamination.

Corresponding author
Rush University Medical Center, 1653 W. Congress Pkwy., Chicago, IL 60612 (
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1. D Pittet , B Allegranzi , H Sax , et al.Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis 2006;6:641652.

2. MJ Bonten , MK Hayden , C Nathan , et al.Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 1996;348:16151619.

3. AR Tenorio , SM Badri , NB Sahgal , et al.Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant Enterococcus species by health care workers after patient care. Clin Infect Dis 2001;32:826829.

5. AJ Ray , CK Hoyen , TF Taub , EC Eckstein , CJ Donskey . Nosocomial transmission of vancomycin-resistant enterococci from surfaces. JAMA 2002;287:14001401.

6. AN Duckro , DW Blom , EA Lyle , RA Weinstein , MK Hayden . Transfer of vancomycin-resistant enterococci via health care worker hands. Arch Intern Med 2005;165:302307.

7. E Larson , C Friedman , J Cohran , J Treston-Aurand , S Green . Prevalence and correlates of skin damage on the hands of nurses. Heart Lung 1997;26:404412.

9. MK Hayden , MJ Bonten , DW Blom , EA Lyle , DA van de Vijver , RA Weinstein . Reduction in acquisition of vancomycin-resistant Enterococcus after enforcement of routine environmental cleaning measures. Clin Infect Dis 2006;42:15521560.

13. KY Liang ZS. Longitudinal data analysis using generalized linear models. Biometrika 1986;73:1322.

14. D Pittet , S Dharan , S Touveneau , V Sauvan , TV Perneger . Bacterial contamination of the hands of hospital staff during routine patient care. Arch Intern Med 1999;159:821826.

16. WE Trick , MO Vernon , RA Hayes , et al.Impact of ring wearing on hand contamination and comparison of hand hygiene agents in a hospital. Clin Infect Dis 2003;36:13831390.

20. SS Huang , R Datta , R Piatt . Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch Intern Med 2006;166:19451951.

21. JA Martinez , R Ruthazer , K Hansjosten , L Barefoot , DR Snydman . Role of environmental contamination as a risk factor for acquisition of vancomycin-resistant enterococci in patients treated in a medical intensive care unit. Arch Intern Med 2003;163:19051912.

22. ES McBryde , DL McElwain . A mathematical model investigating the impact of an environmental reservoir on the prevalence and control of vancomycin-resistant enterococci. J Infect Dis 2006;193:14731474.

23. MO Vernon , MK Hayden , WE Trick , RA Hayes , DW Blom , RA Weinstein . Chlorhexidine gluconate to cleanse patients in a medical intensive care unit: the effectiveness of source control to reduce the bioburden of vancomycin-resistant enterococci. Arch Intern Med 2006;166:306312.

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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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