Closeup image of gloved hands spraying surface with disinfectant for infection control

The shoes of workers, wheelchair wheels and flooring are potential sources of drug-resistant pathogen spread in long-term care settings, finds a new study.

In a simulation, investigators followed the path of methicillin-resistant Staphylococcus aureus from the rooms of 12 infected patients at a Cleveland nursing facility. Personnel with disinfected shoes walked into the residents’ rooms and then into adjacent, disinfected rooms.

After three to four simulations for each room, they measured the prevalence of MRSA on the floors of the adjacent rooms. They also experimented with water containing a benign virus, checking for contamination of floors and high-touch surfaces in the nursing station and adjacent rooms, according to a report on the study by CIDRAP News.

Frequent transfer

MRSA contamination on the floors of the infected long-term care facility residents was frequently transferred to adjacent resident rooms, reported Curtis J. Donskey, MD, of Case Western Reserve University in Cleveland, and colleagues. 

The drug-resistant bug spread to 47% (18 of 38) of the assessments in adjacent room 1, and in 32% of assessments in adjacent room 2. The more heavily contaminated the room, the more MRSA was spread, CIDRAP reported.

Nursing station and surfaces 

What’s more, the benign virus simulation also showed a high (50%) rate of contamination to adjacent resident rooms and the nursing station, and contamination from 33% to 70% of high-touch surfaces in all rooms and the nursing station.

Contaminated floors, shoes and wheelchair wheels could be underappreciated sources of pathogen spread in such settings, the authors said.

“These results suggest that shoes may serve as a vector for dissemination of healthcare-associated pathogens from rooms of MRSA-colonized patients,” they concluded.

The study was published in the American Journal of Infection Control.

Related articles:

C. diff may sneak in on soles of shoes, sampling study shows

MRSA and VRE persist in resident rooms, nursing home study finds

These risk factors signal high mortality in multidrug-resistant infections: study

CDC: Deaths from antibiotic-resistant bacteria jumped 15% in 2020

Stewardship engagement slashes antibiotic use across hundreds of LTCFs