番茄社区

BOSTON -- The gloves healthcare workers wear to protect themselves from pathogens can transmit multidrug resistant bacteria if they're not used properly, a researcher said here.

In an experimental study, seven important pathogens were easily transmissible from nitrile gloves to a polypropylene surface, according to Kazue Fujita, MD, ofin Tokyo.

But six of them decreased in number very quickly, Fujita told reporters at the ASM Microbe meeting.

However, the seventh and eighth -- drug-sensitive and -resistant Acinetobacter baumannii -- could survive for up to 3 minutes on the glove and be transmitted to the surface, Fujita said.

That raises scenarios in which a multidrug resistant strain of A. baumannii contaminates a caregiver's gloves and is transferred to a surface in the room, or in the next patient's room, carrying resistance genes that can jump into other pathogens, such as Escherichia coli or Klebsiella pneumoniae.

"It's a great study [and] very important," commented of the Medical University of South Carolina in Charleston, and a spokesman for the .

"It's all about the movement of resistance," he told 番茄社区. "The gloves can move the microbes."

Caregivers don't wash gloves between patients and, importantly, they don't always strip them off as soon as they have been in contact with blood or other body fluids from a patient, he said.

"You're protected, but now the glove is contaminated and you have a failure of hand hygiene," Schmidt said.

Multidrug resistant A. baumannii is particularly worrisome because it contains plasmids -- short sections of DNA -- that carry resistance-associated genes. Those plasmids, in turn, can easily jump into pathogens of other species.

A gap in the study as presented, Schmidt said, is the background rate of infection in Fujita's hospital, and what role the investigators think improper use of gloves is playing. "That's the next step," he said.

That contaminated gloves are risky is not surprising as it has been reported before in observational studies, Fujita said. What's new and different here is that the researchers pinned down which pathogens are transmissible and for how long.

They tested eight agents:

• E. coli and its drug-resistant version, extended-spectrum beta-lactamase (ESBL) -producing E. coli
• K. pneumoniae and ESBL-producing K. pneumoniae
• Both drug-sensitive and -resistant A. baumannii
• And drug-sensitive and -resistant P. aeruginosa

They inoculated nitrile examination gloves with 10⁵, 10³ and 10 colony-forming units (CFU) of each microorganism per 10 μl of fluid.

Immediately after inoculation, 30 seconds later, and 3 minutes later (by which time the gloves had dried completely) the contaminated gloves were touched to a sterilized polypropylene surface and the number of viable bacteria on the polypropylene surface were quantified.

At 0 seconds, all of the pathogens transmitted 5% to 10% of the inoculum to the polypropylene surface. All except A. baumannii decreased transmission in dose- and time-dependent fashion and were not detected on the surface when the gloves were touched after 3 minutes.

But both sensitive and resistant A. baumannii were able to be transferred even when the gloves had dried completely, Fujita said.

Antibiotic sensitivity or resistance did not appear to have a consistent effect on how long the bacteria survived on the polypropylene surface, Fujita's group found.

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