Universal use of gloves and gowns reduces MRSA but not VRE

Hospitals that require clinicians to wear gowns and gloves in ICUs reduced methicillin-resistant Staphylococcus aureus (MRSA) infections, but not vancomycin-resistant Enterococcus (VRE) infections, according to a study published in the Journal of the American Medical Association (JAMA).

Between January and October 2012, researchers from the University of Maryland School of Medicine asked staff at 10 ICUs nationwide to wear gowns and gloves whenever they treated a patient. At another 10 hospitals, staff only wore them when treating patients who were known to have infections. During this period, they collected and tested swabs from more than 26,000 patients.

At the end of the study period, hospitals with a universal gown-and-glove policy reported a 40 percent decrease in MRSA infections, but no significant decrease in VRE infections. Consequently, the policy did not have a statistically significant effect on infection rates overall, according to the study.

"Although there was a lower risk of MRSA acquisition alone [with gowns and gloves] and no difference in adverse events, these secondary outcomes require replication before reaching definitive conclusions," wrote lead researcher Anthony Harris, M.D., and his team.

Although the researchers could not draw a conclusion about the policy, Harris said, it was still a good practice for hospitals, especially those with high MRSA infection rates. "For individual ICUs where [hospital officials] know what the rate of MRSA infections are among ICU patients, or know in the surrounding state what the prevalence of MRSA is," Harris told Time magazine, "the short answer is yes, we think they should use data like this to make the decision about universal contact precautions."

One reason many hospitals do not require gowns and gloves already is because prior studies indicate the suiting-up process reduces the number of patient visits and increases rates of adverse events. Harris, however, said during the study, there were fewer adverse events in hospitals with the universal policy, according to Time.  

A September study in JAMA found hospital-related MRSA infection rates declined by more than 50 percent between 2006 and 2011, but the decrease in community-associated infections was much smaller.

To learn more:
- here's the study
- read the Time article

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