Lyndsay M O'Hara, Michelle Newman, Alison D Lydecker, Gwen L Robinson, Aaron Hong, Christina Boucher, Patience Osei, Erin K Molloy, J Kristie Johnson, Ayse P Gurses, Heather Jones, Kara Jacobs Slifka, Mary-Claire Roghmann
{"title":"加强屏障预防，以防止传播金黄色葡萄球菌和碳青霉烯耐药的有机体在养老院慢性呼吸机单位。","authors":"Lyndsay M O'Hara, Michelle Newman, Alison D Lydecker, Gwen L Robinson, Aaron Hong, Christina Boucher, Patience Osei, Erin K Molloy, J Kristie Johnson, Ayse P Gurses, Heather Jones, Kara Jacobs Slifka, Mary-Claire Roghmann","doi":"10.1017/ice.2025.10237","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Assess the feasibility and effect of Enhanced Barrier Precautions (EBP) on the transmission of <i>Staphylococcus aureus</i> (SA) and carbapenem-resistant organisms (CRO) among residents in nursing home chronic ventilator units (NH-CVU).</p><p><strong>Design: </strong>Pre-post interventional study.</p><p><strong>Setting: </strong>Two community-based nursing homes with CVUs in Maryland. A total of 56 residents were enrolled in the baseline period and 64 residents were enrolled in the intervention period.</p><p><strong>Methods: </strong>During a 3-month baseline and intervention period, residents were swabbed monthly to estimate SA and CRO acquisition. During a 2-month training period, EBP was implemented for residents with chronic wounds, medical devices, or history of multidrug-resistant organism (MDRO) colonization. During the subsequent 3-month intervention period, healthcare personnel (HCP) wore gowns and gloves for high-contact care activities when residents were on EBP. Whole genome sequencing assessed resident-to-resident transmission.</p><p><strong>Results: </strong>At baseline, NH-CVU1 used gowns and gloves for all direct contact, while NH-CVU2 used EBP only for residents with a history of MDRO colonization. After training, the proportion of NH-CVU2 residents on EBP increased from 65% in the baseline period to 87% in the intervention period. Glove use was high (93-98%) in both NH-CVUs. Gown use increased from 39% to 77% in NH-CVU1 and from 26% to 72% in NH-CVU2. Resident-to-resident transmission of SA or CRO decreased by 25% in NH-CVU1 (<i>p</i> = 0.60) and by 67% in NH-CVU2 (<i>p</i> = 0.05). CRO transmission decreased by 33% in NH-CVU1 (<i>p</i> = 0.54) and by 83% in NH-CVU2 (<i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>EBP is feasible and potentially decreases overall and CRO transmission in nursing home CVUs.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.9000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Enhanced barrier precautions to prevent transmission of <i>Staphylococcus aureus</i> and Carbapenem-resistant organisms in nursing home chronic ventilator units.\",\"authors\":\"Lyndsay M O'Hara, Michelle Newman, Alison D Lydecker, Gwen L Robinson, Aaron Hong, Christina Boucher, Patience Osei, Erin K Molloy, J Kristie Johnson, Ayse P Gurses, Heather Jones, Kara Jacobs Slifka, Mary-Claire Roghmann\",\"doi\":\"10.1017/ice.2025.10237\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Assess the feasibility and effect of Enhanced Barrier Precautions (EBP) on the transmission of <i>Staphylococcus aureus</i> (SA) and carbapenem-resistant organisms (CRO) among residents in nursing home chronic ventilator units (NH-CVU).</p><p><strong>Design: </strong>Pre-post interventional study.</p><p><strong>Setting: </strong>Two community-based nursing homes with CVUs in Maryland. A total of 56 residents were enrolled in the baseline period and 64 residents were enrolled in the intervention period.</p><p><strong>Methods: </strong>During a 3-month baseline and intervention period, residents were swabbed monthly to estimate SA and CRO acquisition. During a 2-month training period, EBP was implemented for residents with chronic wounds, medical devices, or history of multidrug-resistant organism (MDRO) colonization. During the subsequent 3-month intervention period, healthcare personnel (HCP) wore gowns and gloves for high-contact care activities when residents were on EBP. Whole genome sequencing assessed resident-to-resident transmission.</p><p><strong>Results: </strong>At baseline, NH-CVU1 used gowns and gloves for all direct contact, while NH-CVU2 used EBP only for residents with a history of MDRO colonization. After training, the proportion of NH-CVU2 residents on EBP increased from 65% in the baseline period to 87% in the intervention period. Glove use was high (93-98%) in both NH-CVUs. Gown use increased from 39% to 77% in NH-CVU1 and from 26% to 72% in NH-CVU2. Resident-to-resident transmission of SA or CRO decreased by 25% in NH-CVU1 (<i>p</i> = 0.60) and by 67% in NH-CVU2 (<i>p</i> = 0.05). CRO transmission decreased by 33% in NH-CVU1 (<i>p</i> = 0.54) and by 83% in NH-CVU2 (<i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>EBP is feasible and potentially decreases overall and CRO transmission in nursing home CVUs.</p>\",\"PeriodicalId\":13663,\"journal\":{\"name\":\"Infection Control and Hospital Epidemiology\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-08-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infection Control and Hospital Epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/ice.2025.10237\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Control and Hospital Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/ice.2025.10237","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Enhanced barrier precautions to prevent transmission of Staphylococcus aureus and Carbapenem-resistant organisms in nursing home chronic ventilator units.
Objective: Assess the feasibility and effect of Enhanced Barrier Precautions (EBP) on the transmission of Staphylococcus aureus (SA) and carbapenem-resistant organisms (CRO) among residents in nursing home chronic ventilator units (NH-CVU).
Design: Pre-post interventional study.
Setting: Two community-based nursing homes with CVUs in Maryland. A total of 56 residents were enrolled in the baseline period and 64 residents were enrolled in the intervention period.
Methods: During a 3-month baseline and intervention period, residents were swabbed monthly to estimate SA and CRO acquisition. During a 2-month training period, EBP was implemented for residents with chronic wounds, medical devices, or history of multidrug-resistant organism (MDRO) colonization. During the subsequent 3-month intervention period, healthcare personnel (HCP) wore gowns and gloves for high-contact care activities when residents were on EBP. Whole genome sequencing assessed resident-to-resident transmission.
Results: At baseline, NH-CVU1 used gowns and gloves for all direct contact, while NH-CVU2 used EBP only for residents with a history of MDRO colonization. After training, the proportion of NH-CVU2 residents on EBP increased from 65% in the baseline period to 87% in the intervention period. Glove use was high (93-98%) in both NH-CVUs. Gown use increased from 39% to 77% in NH-CVU1 and from 26% to 72% in NH-CVU2. Resident-to-resident transmission of SA or CRO decreased by 25% in NH-CVU1 (p = 0.60) and by 67% in NH-CVU2 (p = 0.05). CRO transmission decreased by 33% in NH-CVU1 (p = 0.54) and by 83% in NH-CVU2 (p = 0.02).
Conclusions: EBP is feasible and potentially decreases overall and CRO transmission in nursing home CVUs.
期刊介绍：
Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. Written by infection control practitioners and epidemiologists and guided by an editorial board composed of the nation''s leaders in the field, ICHE provides a critical forum for this vital information.
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