Patients commonly bring multidrug-resistant organisms (MDROs) on their hands when they are discharged from a hospital to a post-acute care facility and then they acquire more MDROs during their time there, according to an article published online by JAMA Internal Medicine.
MDROs are increasingly prevalent at post-acute care facilities because of contact between health care workers, the environment and patients, who are encouraged to be mobile outside their rooms. Patients’ hands come into contact with surfaces, health care workers’ hands and other patients in these post-acute care facilities.
Lona Mody, M.D., M.Sc., of the University of Michigan Medical School, Ann Arbor, and coauthors evaluated baseline, new acquisitions and duration of MDROs on the hands of patients newly admitted to post-acute care facilities from acute care hospitals.
The study followed 357 patients (54.9 percent female with an average age of 76 years). The dominant hands of patients were swabbed at baseline when they were enrolled in a post-acute care facility, at day 14 and then monthly for up to 180 days or until discharge.
The study found:
- Nearly one-quarter (86 of 357) of patients had at least one MDRO on their hands when they were discharged from the hospital to the post-acute care facility.
- During follow-up, 34.2 percent of patients’ hands (122 of 357) were colonized with an MDRO and 10.1 percent of patients (36 of 357) newly acquired one or more MDROs.
- Overall, 67.2 percent of MDRO-colonized patients (82 of 122) remained colonized at discharge.
“Owing to PAC [post-acute care] patients’ increased mobility and interaction with the environment, health care workers and other patients, we believe that it is even more important to implement routines that enforce washing of patients’ hands than in the acute care setting,” the study concludes.