Hospitals may be cracking down on handwashing for doctors, nurses and other staffers, but they're missing a big source of superbug spread, a new study finds: Patients.
Researchers at the University of Michigan found close to a quarter of the patients they tested had some sort of drug-resistant germ on their hands when they were discharged from the hospital to a post-acute care facility such as a nursing home, rehabilitation center or hospice.
The finding, publishing in the Journal of the American Medical Association's JAMA Internal Medicine, supports what many health care experts have been arguing for years: that patients are a major source of the spread of "superbug" infections.
About 2 million people get sick every year with antibiotic-resistant infections in the U.S. and about 23,000 die. The Centers for Disease Control and Prevention says one in 25 U.S. hospital patients has caught an infection while in the hospital.
Healthcare workers are known source of the spread, as are contaminated instruments. Dr. Lona Mody of the University of Michigan Medical School looked at another suspected source: patients.
They studied patients at six post-hospital facilities in metropolitan Detroit and Southeast Michigan.
"We swabbed the palm, fingers, and around nails of patients' hands," they wrote. The tests were done when patients were admitted, two weeks later and then once a month for the next six months.
They tested for a number of bugs, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and resistant gram-negative bacilli.
More than 24 percent of the patients had at least one of these germs on their hands when they were discharged from the hospital, Mody's team found. And more got them in the rehabs and nursing homes.
"During follow-up, 34.2 percent of patients' hands (122 of 357) were colonized with a multi-drug-resistant organism," they wrote.
And of them, two-thirds still had the germs on their hands when they were discharged from the rehab facility or nursing home.
"Our study shows that patients commonly bring multi-drug-resistant organisms on their hands on discharge from an acute care hospital and acquire more during their stay at the post-acute care facility," the team wrote.
"This, combined with frequent antibiotic use in post-acute care patients, increases the probability that multi-drug-resistant organisms introduced to a post-acute care facility will be transmitted to other frail patients and to health care workers — and, most important, that the (germ) will persist in the facility," they wrote.
"Despite concerns raised by some recent studies, patient hand-washing is not a routine practice in hospitals to date."