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NHSN Annual Update:
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections

Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006–2007

Antimicrobial-resistant pathogens that cause healthcare-associated infections (HAIs) pose an ongoing and increasing challenge to hospitals, both in the clinical treatment of patients and in the prevention of the cross-transmission of these problematic pathogens.  Describing the magnitude of the problem with respect to these antimicrobial-resistant pathogens is challenging, because the levels of antimicrobial resistance vary for different types of healthcare facilities and for different geographic areas, and some resistance phenotypes are difficult for laboratories to detect. However, the findings from such attempts may help the infection control and public health communities target problems and utilize resources more efficiently.

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October 2007

Volume 28, Number 10
Infect Control Hosp Epidemiol 2007;28:1148–1154
© 2007 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2007/2810-0004$15.00
DOI: 10.1086/520734
Original Article

Preventing the Airborne Spread of Staphylococcus aureus by Persons With the Common Cold: Effect of Surgical Scrubs, Gowns, and Masks

Werner E. Bischoff, MD, PhD;

Brian K. Tucker, BS;

Michelle L. Wallis, BS;

Beth A. Reboussin, PhD;

Michael A. Pfaller, MD;

Frederick G. Hayden, MD;

Robert J. Sherertz, MD

From the Sections on Infectious Diseases (W.E.B., B.K.T., M.L.W., R.J.S.) and Biostatistics (B.A.R.), Wake Forest University School of Medicine, Winston‐Salem, North Carolina; the Medical Microbiology Division, University of Iowa Hospitals and Clinics, Iowa City, Iowa (M.A.P.); and the Division of Infectious Diseases and International Health, University of Virginia Health Sciences Center, Charlottesville, Virginia (F.G.H.).

Objective.Transmission of Staphylococcus aureus via air may play an important role in healthcare settings. This study investigates the impact of barrier precautions on the spread of airborne S. aureus by volunteers with experimentally induced rhinovirus infection (ie, the common cold).

Design.Prospective nonrandomized study.

Setting.Wake Forest University School of Medicine (Winston‐Salem, NC).

Participants.A convenience sample of 10 individuals with nasal S. aureus carriage selected from 593 students screened for carriage.

Intervention.Airborne S. aureus dispersal was studied in the 10 participants under the following clothing conditions: street clothes, surgical scrubs, surgical scrubs and a gown, and the latter plus a face mask. After a 4‐day baseline period, volunteers were exposed to a rhinovirus, and their clinical course was followed for 12 days. Daily swabs of nasal specimens, pharynx specimens, and skin specimens were obtained for quantitative culture, and cold symptoms were documented. Data were analyzed by random‐effects negative binomial models.

Results.All participants developed a common cold. Incidence rate ratios (IRRs) indicated that, compared with airborne levels of S. aureus during sessions in which street clothes were worn, airborne levels decreased by 75% when surgical scrubs were worn ( ), by 80% when scrubs and a surgical gown were worn ( ), and by 82% when scrubs, a gown, and a face mask were worn ( ). The addition of a mask to the surgical scrubs and gown did not reduce the airborne dispersal significantly (IRR, 0.92; ). Male volunteers shed twice as much S. aureus as females (incidence rate ratio, 2.04; ). The cold did not alter the efficacy of the barrier precautions.

Conclusions.Scrubs reduced the spread of airborne S. aureus, independent of the presence of a rhinovirus‐induced cold. Airborne dispersal of S. aureus during sessions in which participants wore surgical scrubs was not significantly different from that during sessions in which gowns and gowns plus masks were also worn.

Received January 30, 2007; accepted May 14, 2007; electronically published August 29, 2007.

Address reprint requests to Werner E. Bischoff, MD, PhD, Wake Forest University School of Medicine, Department of Internal Medicine, Section on Infectious Diseases, Medical Center Boulevard, Winston‐Salem, NC 27157‐1042 ().

Cited by

T. Coates, R. Bax, A. Coates. (2009) Nasal decolonization of Staphylococcus aureus with mupirocin: strengths, weaknesses and future prospects. Journal of Antimicrobial Chemotherapy 64:1, 9-15
Online publication date: 1-Aug-2009.
CrossRef

  • Presented in part: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy; San Francisco, CA; September 27– September 30, 2006 (Abstract K‐1676).

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