One in four seniors discharged from the hospital is bringing along some stowaways — superbugs on the hands, according to a recent study.
The findings from researchers at the University of Michigan, Ann Arbor, also show seniors who go to a nursing home or other post-acute care facility will acquire new superbugs during their stay. Results were published March 14 in a research letter in JAMA Internal Medicine.
According to a story by HealthDay reporter Alan Mozes, investigators looked at multidrug resistant organism rates in post-acute recovery facilities seniors often stay in before returning home. Researchers focused on 357 seniors who recently had been admitted to the hospital for a medical or surgical issue and were sent to several PAC facilities in southeast Michigan before returning home, according to a UM news story. One-quarter of these patients (24.1%) had at least one multidrug-resistant organism on their hands when they checked into the PAC facility.
Researchers tested the same patients’ hands after two weeks and then monthly, for as long as six months or until their discharge home from the PAC facility. During the follow-up tests, they found not only did these organisms persist, but also even more seniors acquired superbugs on their hands — increasing from 24.1% to 34.2%.
“We’ve been educating healthcare workers for decades about hand hygiene, and these numbers show it’s time to include patients in their own hand hygiene performance and education,” lead author Lona Mody, MD, MSc, said in the UM story. Mody is the associate chief for clinical and translational research at the U-M Geriatrics Center and a research scientist at the Ann Arbor VA Geriatrics Research Education and Clinical Center.
Because of overuse of antibiotics in many healthcare settings, certain strains of several infectious bacteria have evolved to be resistant to treatment with the drugs — making them even more dangerous than other strains.
According to the CDC, about 2 million people become ill with antibiotic-resistant infections and approximately 23,000 die annually from those infections. In a March 11 Morbidity and Mortality Weekly Report, “Vital Signs: Preventing Antibiotic-Resistant Infections in Hospitals — United States, 2014,” the CDC called for increased efforts to prevent superbugs from spreading.
“Patient hand washing is not a routine practice in hospitals,” she said in the UM story. “We need to build on the overarching principles we’ve already developed with adult learning theories and bring them to patients.”
A high level of MDROs on patient hands increases the chance these superbugs will be transmitted to other frail patients and healthcare workers. Frequent antibiotic use in post-acute care patients also increases the probability that MDROs introduced to a post-acute care facility will flourish.
Mody and her team developed a toolkit for PACs to use in training employees to control infections, called the TIP study toolkit. The kit, which could be adapted to a patient audience, includes:
• Educational posters about hand hygiene.
• Educational modules and trivia questions about hand hygiene.
• An infection preventionist on-site to ensure availability of hand hygiene products, including alcohol gel for personal use.
However, Philip Tierno, PhD, a professor of microbiology and pathology with the NYU School of Medicine at NYU Langone Medical Center in New York City, said in Mozes’ story that it’s important to place the findings in context.
“Germ transmission by hand is certainly a big problem,” he said in the story. “And clearly hand-washing is very important. But it should be understood that this study did not prove, for example, that the patients picked up their germs in the hospitals they came from.”
According to Mozes, Tierno said patients might have brought the superbugs with them to the hospital when they were first admitted.
“Because it’s the Wild West out there,” he said in the story. “Resistant germs are not just in hospitals. They’re everywhere.”
Tierno said to make headway fighting antibiotic-resistant germs, everyone needs to follow proper hand hygiene advice, not just patients, according to Mozes.
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