Highlights
- •Limited information is available on shedding of pathogens outside patient rooms.
- •We examined shedding during appointments outside patient rooms.
- •38.5% of MRSA-colonized patients shed MRSA during appointments.
- •Presence of wounds with MRSA was a significant risk for environmental shedding.
- •No shedding of multidrug-resistant gram-negative bacilli was detected.
Background
Limited information is available on the frequency of and risk factors for shedding
of health care-associated pathogens in settings outside patient rooms.
Methods
We conducted a cohort study of hospitalized or recently discharged patients with methicillin-resistant
Staphylococcus aureus (MRSA) (N = 39) or multidrug-resistant gram-negative bacilli (MDR-GNB) (N = 11) colonization
to determine the frequency of environmental shedding during appointments outside hospital
rooms or during outpatient clinic visits. Chi-square tests were performed to identify
patient-level factors associated with environmental shedding. Spa typing was performed
for environmental and nasal MRSA isolates.
Results
Of 50 patients enrolled, 39 were colonized with MRSA and 11 with MDR-GNB. Shedding
during 1 or more appointments occurred more often for patients colonized with MRSA
versus MDR-GNB (15 of 39, 38.5% versus 0 of 11, 0%; P = .02). The presence of a wound with a positive culture for MRSA was associated with
shedding of MRSA during appointments (11 of 15, 73.3% with shedding versus 4 of 24,
16.7% with no shedding; P = .008). Eighty percent of environmental MRSA isolates were genetically related to
concurrent nasal isolates based on spa typing.
Conclusions
Environmental shedding of MRSA occurs frequently during appointments outside hospital
rooms or during outpatient clinic visits. Decontamination of surfaces and strategies
that reduce shedding of MRSA could reduce the risk for transmission in these settings.
Key Words
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Article Info
Publication History
Published online: March 09, 2021
Footnotes
Funding: The authors acknowledge funding from the Centers for Disease Control and Prevention's investments to combat antibiotic resistance under award number 2019-06723 to CJD.
Conflicts of interest: C.J.D. has received research funding from Clorox, PDI, and Pfizer. All other authors report no conflicts of interest relevant to this article.
Identification
Copyright
Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
