Contamination of gowns, gloves, and stethoscopes with vancomycin-resistantenterococci

OBJECTIVE: To measure directly the rate of contamination, during routine pa tient examination, of gowns, gloves, and stethoscopes with vancomycin-resis tant enterococci (VRE). SETTING: A large, academic, tertiary-care hospital. PATIENTS: Between January 1997 and December 1998, 49 patients colonized or infected with VRE were entered in the study. DESIGN: After routine examination, the examiner's glove fingertips, gown (t he umbilical region and the cuffs), and stethoscope diaphragm were pressed onto Columbia colistin-nalidixic acid (CNA) agar plates with 5% sheep blood plus vancomycin 6 mug/mL. The stethoscope diaphragm was sampled again afte r cleaning with a 70% isopropanol wipe. RESULTS: VRE were isolated from at least 1 examiner site (gloves, gowns, or stethoscope) in 33 (67%) of 49 cases. Gloves were contaminated in 63%, gow ns in 37%, and stethoscopes in 31%. All three items were positive for VRE i n 24%. One case each had stethoscope and gown contamination without glove c ontamination. Only 1 (2%) of 49 stethoscopes was positive after wiping with an alcohol swab. Contamination at any site was more likely when the patien t had a colostomy or ileostomy. Patients identified by rectal-swab culture alone were as likely to contaminate their examiners as were those identifie d by clinical specimens. CONCLUSIONS: Our study revealed a high rate of examiner contamination with VRE. The similar risk of contamination identified by surveillance and clini cal cases reinforces concerns that patients not known to be colonized with VRE could serve as sources for dissemination. Wiping with alcohol is effect ive in decontaminating stethoscopes (Infect Control Hosp Epidemiol 2001;22: 560-564).